All You Need to Know About Antibiotics and Supporting Gut Health During Treatment

Most of us have been on a course of antibiotics at some point in our lives, and if you’ve ever suffered from a bad bacterial infection you’ll know just how important these medicines are. But with all the different types of antibiotics available and the sometimes conflicting information about their use, things can get confusing! That’s why, in this blog, Meaghers MD and pharmacist Oonagh O’Hagan is here to clear up any misconceptions and share her expertise on all things antibiotics. 

What are antibiotics?

When you have an infection, there is bacteria present in your body that shouldn’t be there. Think of that bacteria being an intruder in your system. Your body reacts to the intruder by, for example, increasing your temperature in an attempt to kill the bad bacteria, or using signalling such as pain or inflammation to alert your immune system to the intruder. Antibiotics work by killing this bad bacteria, or intruder, and battle alongside your own immune system to improve the symptoms of the infection. 

Types of antibiotics

Antibiotics fall into two main groups. Broad spectrum antibiotics target and treat a broad range of bacteria types. These can be used for a variety of conditions such as:

• Respiratory infections
• Ear infections
• Urinary Tract Infections (UTIs) 
• Sinus infections 

The most common examples used in Ireland are:

• Amoxicillin/clavulanic acid which is a combination of penicillin, doxycycline and clarithromycin
• Trimethoprim or nitrofurantoin (common for UTIs) 

Narrow spectrum antibiotics are much more specific in their target and generally focus on one type of bacteria or infection. An example of this would be soft tissue infections like cellulitis caused by the Staphylococcus group of bacteria, in which case we would see drugs like flucloxacillin used. Penicillin G is another specific antibiotic used to treat Streptococcus infections commonly involved in strep throat. 

Things to remember when taking antibiotics

Take your antibiotics as prescribed

The most important thing to remember when taking antibiotics is that you must take the medicine as prescribed. So if, for example, you are directed to take one tablet three times a day for seven days, you must take the medicine in this way. 

Take the full course of antibiotics 

Symptoms will often start to improve after a few days of taking antibiotics but you must continue to finish the course regardless. This is vital for the medicine to act effectively and to reduce antibiotic resistance. 

Take your antibiotics at the instructed time

If the prescribed dose is one tablet in the morning and one in the evening then take them as instructed as this means that the drug will work best at those times. The morning dose helps to keep the correct level of antibiotic in your blood during the day and then the evening dose helps maintain this overnight as the morning dose starts to be less effective. Some antibiotics become less effective quicker and so need to be taken more often throughout the day.

Other things that you can do to ensure your antibiotic is most effective are simple things like drink a full glass of water when taking the tablet, not just a sip, as you are then giving the tablet a greater chance to dissolve effectively in your tummy. 

If the directions say to take with food, that is important. Some drugs are not very soluble in water but dissolve better with oily substances. Because food is made up of a mixture of fats and water, certain drugs will be absorbed more effectively when taken with a meal. In some cases the antibiotics can themselves be hard on the tummy and may cause nausea. Taking them with food when instructed can help to protect you from this side effect. 

Please read the pharmacy label on your medicine and follow the instructions. If you have any questions or concerns ask your pharmacist, we are there to help you understand your medicines.

Things to avoid when taking antibiotics 

It is advised to avoid grapefruit when taking antibiotics, as it can interact with certain types. Some other antibiotics interact with alcohol too, so check with your pharmacist if you are unsure. 

Antibiotics can upset the bacterial balance in our gut which can cause side effects such as nausea or diarrhoea. If you experience these symptoms, it is best to avoid foods that might further contribute to these symptoms. Try to avoid processed foods as much as possible as these can also harm your gut bacteria, and aim to eat a whole food diet, drink lots of water, and rest while your body fights off the infection.

Antibiotics and gut health

Our gut is full of billions of bacteria - thousands of different species, some good and some bad. In fact, there are more bacteria in our body than there are human cells! We feed these bacteria and allow them to thrive and in return they do many things for us. They help to digest our food and produce certain vitamins and other compounds that are good for our health. They train our immune system, help with detoxification, and play a positive role in our hormone, metabolic, skin and mental health too. In fact, scientists are only just beginning to understand the many bodily processes our gut bacteria are involved in. 

All these bacteria, together with viruses, fungi and protozoa contribute to the community of microorganisms in the gut commonly called the gut microbiome. It’s really important that we do all we can to protect our microbiome and allow these organisms to grow and thrive so that they can work optimally. 

The challenge when it comes to antibiotics is that they often work indiscriminately, so while they kill the bad bacteria that’s causing the infection, they will also kill the good bacteria that normally resides in the gut, which then has a negative impact on your gut microbiome. My advice is to take a gut health supplement during the course of antibiotics and after you finish the course in order to repair the damage to the good bacteria and restore the microbiome to optimal levels again.

Restoring gut health after antibiotics 

One single antibiotic can wipe out many of the good bacteria in your gut microbiome and in some cases it can take up to a year to restore that balance. So, after a course of antibiotics, it’s a great time to encourage the growth of good bacteria in the gut as this will help to restore the balance much faster. The BDA (British Dietetic Association) food factsheet on ‘Probiotics and Gut Health’ recognises the benefit of using probiotics alongside antibiotics and continuing their use for at least one-week post-antibiotics. These recommendations are based on research. Best practice suggests the use of a probiotic from the start of an antibiotic course through to at least 1 week post-antibiotics, and taking the probiotic at a different time to the antibiotic will enhance the impact of the probiotic by maximising the chance of the good bacteria surviving.

My go-to recommendation is Symprove. In my opinion it is the most effective gut health supplement I have experienced and it’s backed up by clinical data. Clinical evidence shows that all the bacteria in your daily dose of Symprove pass through the stomach within 10 minutes and are ready to get straight to work. The four strains of bacteria in Symprove are alive when they enter your body and because they are suspended in a water-based solution which is acidic in nature, the bacteria are accustomed to living in an acidic environment and can survive the harsh acidic environment of your stomach. They grow and thrive when they reach your large intestine which is where over 90% of your microbiome resides. Symprove should be taken first thing in the morning on an empty stomach and you should wait ten minutes before taking any other food or drink to allow the bacteria time to pass from your stomach into your intestines. Taking Symprove, including fermented foods in your diet (these are another good source of beneficial bacteria) and increasing dietary fibre will help to restore the good bacteria in the gut, reducing unwanted side effects of antibiotics. Including plenty of colour in your fruit and vegetables when recovering from an infection is also a brilliant idea. The colours represent polyphenols which are powerful antioxidants. Polyphenols are superfoods for your gut bacteria and will help them flourish and grow much faster, so ensure you have lots of colour in your diet.

Finally..

As a pharmacist it is really important for me to emphasise that antibiotics are lifesaving essential medicines and if prescribed should be taken exactly as directed by your doctor. Don’t be fearful of taking antibiotics. 

It is however important to be aware of what antibiotics do when they enter your body so that you can take some steps to mitigate the damage they cause to your good gut bacteria. Your gut microbiome plays such an important role not only in your digestive health but in your overall health and wellbeing. When your microbiome is unbalanced and your levels of good bacteria are reduced, this can negatively impact your gut health, immune health, your skin health and many other aspects of your overall health and wellbeing too. 

If you have any questions, worries or concerns speak to your pharmacist or get in touch with us at Meaghers Pharmacy. We are here to help!