How to recover the microbiota after a treatment with antibiotics

Conventional medicine still acts as if most antibiotics have little effect on gut microbiota, at least not in the long term. The intestinal flora would fully recover within a few weeks of stopping the antibiotics. That is why doctors do not usually accompany the prescription with another one for probiotics or food advice.

However, at least two studies have shown that this is not the case. Antibiotics modify the intestinal flora for a significantly long period of time.

The intestinal microbiota does not fully recover

Researchers at the Marine Biological Laboratory in Woods Hole, Massachusetts (USA), under the direction of Dr. Mitchell Sogin, demonstrated with the help of a highly accurate genetic analysis method that after six months of antibiotic treatment, part of the microbiota had not recovered.

For this study, conducted in collaboration with Stanford University (in Palo Alto, California), scientists analyzed the composition of the gut microbiota in healthy adults who they had ingested an antibiotic over a period of 5 days.

At the start of the treatment, between 3,300 and 5,700 different types of bacteria could be detected in the participants. In the course of antibiotic treatment, a third of the bacteria were severely depleted.

For all other types of bacteria, the proportions changed, so bacteria that were once rare became more common, while strains that were once common suddenly became rare.

This pathological bacterial imbalance is called dysbiosis. All participants in the Woods Hole study were diagnosed with dysbiosis after completing antibiotic treatment.

The intestinal flora is still altered 6 months after antibiotics

In another study, published in Nature Microbiology, researchers from the University of Copenhagen confirmed the above results. They gave 12 healthy young men 3 different antibiotics for 4 days. The drugs led to an almost complete loss of the gut microbiota.

Subsequently, the harmful bacteria of the Clostridial family recovered faster, while the beneficial bacteria were slow to arrive. Over the course of the next 6 months, the gut microbiota slowly recovered, but did not reach its original state, as 9 bacterial strains were missing. beneficial.

Study leader Professor Oluf Pedersen, from the Novo Nordisk Foundation’s Center for Basic Metabolic Research, explained that “Broad-spectrum antibiotics affect the diversity of the intestinal flora and therefore should only be given when there is evidence of an infection.”

What probiotics should be taken after antibiotics?

Probiotics are preparations (capsules or fermented liquids) that contain live strains of intestinal bacteria. If the gut microbiota has been severely depleted by antibiotics, ingested bacterial strains settle and help rebuild a healthy intestinal flora.

It is best to start taking the probiotics while taking the antibiotics and continue afterwards, as in some cases they can prevent antibiotic-related diarrhea.

Yeast are recommended probiotics Saccharomyces (S.) boulardii, Lactobacillus GG, Lactobacillus plantarum, Lactobacillus (L.) reuteri, L. casei, L. rhamnosus, L. delbrueckii subsp. Bulgaricus, Bifidobacterium animalis, and S. thermophilus.

It is advisable to acquire a supplement that includes several of these strains or combine at least two supplements with a single strain. Regarding the dose, the manufacturer’s recommendations should be followed. You can also ask your doctor for a guideline.

antibiotic supplementation can be extended for 4 weeks after finishing antibiotic treatment.

In any case, it is convenient to take the probiotic as far away from the antibiotic as possible (for example, one in the morning, the other in the evening) and ideally just before meals or directly with meals.

It is also necessary to take prebiotics

Unlike probiotics, prebiotics are not probiotic bacteria, but substances that serve as food for beneficial intestinal bacteria. The better the beneficial intestinal bacteria are fed, the better they can multiply and the faster the microbiota as a whole will recover after taking antibiotics.

Prebiotics can include foods rich in inlunin such as artichokes, onions, garlic, asparagus, leeks, dandelion greens and oats.Prebiotically active substances can also be taken as a dietary supplement, for example, GOS (galactooligosaccharides) and FOS (fructooligosaccharides).

Inulin can cause swelling in sensitive people. Therefore, if you take it as a supplement, start with very small amounts, which are often enough, and increase slowly, if desired, up to the dosage recommended by the manufacturer.

What not to eat after taking antibiotics?

Proper nutrition is very important during and after the consumption of antibiotics. Sweets, sugary drinks, cakes, pasta and white bread favor colonization by potentially pathogenic fungi. Products with sugar and white flour are taboo during and after taking antibiotics.

It is also convenient to limit the consumption of salt and fats, because in excess they are related to dysbiosis.

What to eat to promote the development of intestinal bacteria?

a vegetable diet, low in salt and fat, that contains probiotic foods (sauerkraut, vegetable yogurt, kombucha, etc.) and that is rich in fiber (from vegetables, fruits, legumes and whole grains such as oats) It is especially indicated after taking antibiotics).Turmeric can also be integrated into the diet, as it promotes the balanced development of the intestinal microbiota.Omega-3 fatty acids they favor the diversity of the intestinal flora, with the settlement of many different strains of bacteria. These fatty acids are found in walnuts, flax and chia seeds, and algae supplements with EPA and DHA.

What else can be done to promote the development of intestinal flora?

You should also ensure a lot of physical exercise, since it has a decisive influence on the composition of the intestinal flora, even with a less favorable diet.

Scientific references:

Mitchell L. Sogin et al. The Pervasive Effects of an Antibiotic on the Human Gut Microbiota, as Revealed by Deep 16S rRNA Sequencing, PLoS Biol.Oluf Pedersen et al. Recovery of gut microbiota of healthy adults following antibiotic exposure. Nature Microbiology.