Azithromycin & Probiotics

Azithromycin is a "broad-spectrum" antibiotic that is similar to its much older cousin, erythromycin. Azithromycin is effective against a wide array of bacteria, including staphylococcus, streptococcus, haemophilus and chlamydia, so it can be used for treating a variety of conditions, such as strep throat, ear infections, chronic bronchitis, pneumonia, skin infections and some sexually transmitted diseases. Like all broad spectrum antibiotics, azithromycin does not discriminate between pathogenic bacteria and "friendly" bacteria.

Under normal circumstances, your gastrointestinal tract is colonized by billions of microorganisms, collectively called gut flora, which live in a symbiotic relationship with each other and with you. These microbes influence your immune system in ways that help to protect you from infection by pathogenic organisms. When you take antibiotics to fight an infection, many of the bacteria in your gut are killed, too. This results in a major change in the makeup of your gut flora, and diarrhea or a yeast infection is often the end result.

Probiotics are live microorganisms that can confer some health benefits on their host -- in this case, you. Research has shown that probiotics can reduce the severity of several conditions, including infectious diarrhea, inflammatory bowel disease and allergic eczema. According to a 2009 review in "Anaerobe," probiotic preparations are also useful for preventing and treating diarrhea that is caused by the administration of antibiotics. However, there is limited evidence to show that probiotics help to prevent or treat yeast infections.

Antibiotics destroy bacteria. Since probiotic preparations contain bacteria, their effectiveness can be reduced or completely abolished if they are taken concurrently with an antibiotic. Hence, the practice of taking your antibiotic capsule with a dollop of yogurt will probably do little to prevent antibiotic-associated diarrhea or recolonize your intestine with probiotic organisms. However, if you take your probiotic at least two hours before or after you take your antibiotic, you should gain the desired benefit from both.

Although probiotics offer promise for alleviating several medical conditions, and they have been shown to prevent or ameliorate antibiotic-associated diarrhea, there is no consensus on which strains and what dosages of probiotics are most effective for a given indication. The universal safety of probiotics has not been established, either. For example, probiotics have not been adequately studied in people whose immune systems are suppressed by disease or medications. If you think probiotics would be helpful for you, talk with a health care professional.