When to take bacteria with antibiotics. Most Effective Probiotics for Rebuilding Intestinal Microflora

Thanks to the invention of antibiotics, mortality from infectious diseases has dropped to negligible numbers. Inflammation of the lungs and intestinal infections, which took millions of lives a hundred years ago, are now treated in a few days, even on an outpatient basis. The name of Louis Pasteur is forever inscribed in the history of medicine.

However, the same Pasteur, who invented the means of fighting the infection, uttered the famous phrase: “Gentlemen! The last word will be for microbes. " And the scientist was absolutely right. As time went on, it became abundantly clear that antibiotics also have their own skeletons in the closet.

The side effects of antibacterial drugs can be as serious as the underlying disease that caused the treatment. A study by American clinicians has proven that antibiotic toxicity has become one of the most common causes of death in hospitalized patients. But don't jump to conclusions.

Let's try to consistently answer the burning questions: why sometimes the use of drugs results in therapy of consequences? And how do you recover from antibiotic treatment?

Antibiotics: side effects

As you know, antibacterial drugs are divided into groups that have a common spectrum of action and similar side effects.

Penicillins

Antibiotics of the penicillin group are generally well tolerated. Among the most common side effects are rashes and exfoliative dermatitis. However, the appearance of antibiotic-associated diarrhea during treatment with penicillins (drugs Amoxicillin, Augmentin, etc.) is not uncommon.

Cephalosporins

All four generations of cephalosporins are considered relatively safe antibiotics. Among the side effects attributed to these drugs is diarrhea. Hypersensitivity reactions are rarely recorded: rash and fever. Ceftazidime, a third generation antibiotic, causes liver dysfunction.

Macrolides

Side effects of macrolides (for example, the antibiotic Sumamed) include nausea, vomiting, diarrhea, rarely antibiotic-associated colitis and cholestatic jaundice.

Fluoroquinolones

When taking these drugs, gastrointestinal symptoms are more often recorded, including diarrhea, abdominal pain, nausea. Allergic reactions such as rash and itching develop much less frequently.

Aminoglycosides

Drugs in this group are among the most toxic. Of particular concern is the nephrotoxicity of aminoglycosides, which manifests itself in the development of acute renal failure, as well as ototoxicity, leading to hearing impairment.

So, the spectrum of side effects of antibacterial drugs is vast. But the most well-known adverse event associated with these treatments is by far antibiotic-associated diarrhea. Let's try to figure out what caused this manifestation and how to deal with it.

Antibiotics and diarrhea: causes

Let's start with the fact that the likelihood of diarrhea or simply diarrhea during treatment with antibacterial agents is not so small: it ranges from 5 to 40%.

Diarrhea during or after antibiotic treatment can be caused by two completely different reasons:

• imbalance of microflora colonizing in the large intestine;
• extremely rapid growth of opportunistic bacteria Clostridium difficile.

Stool disorder caused by changes in the composition of the intestinal flora is the symptom that is commonly called in domestic medicine.

Dysbacteriosis - truth or myth?

Hot debates about dysbiosis have not subsided to this day. Many patients and doctors diligently look for signs of this condition and work to treat it. Meanwhile, Western medicine treats the concept of "dysbiosis" very reservedly.

Note that in Russia there is no nosological unit with this name, that is, there is no such diagnosis officially. This is largely due to the fact that the composition of the intestinal flora is too diverse to establish clear criteria for the norm. Moreover, a healthy person has recovery mechanisms, and they start on their own.

The condition, which we regard as dysbiosis while taking antibiotics, is called antibiotic-associated diarrhea by most European and American experts. The main and often the only symptom of disturbed intestinal microflora is loose stools.

Pseudomembranous enterocolitis is an unfamiliar name for a familiar problem

In about 5–15% of antibiotic use, diarrhea that occurs during or after treatment is caused by an increase in Clostridium difficile. The disease that develops as a result of the multiplication of clostridia is called pseudomembranous enterocolitis. Most often, this complication is recorded in patients undergoing inpatient treatment.

The diagnosis of pseudomembranous enterocolitis is suggested primarily in any patient with diarrhea who has taken antibiotics in the previous three months and has been hospitalized.

Symptoms of pseudomembranous enterocolitis include:

• mild to moderately severe watery diarrhea;
• cramping abdominal pain;
• lack of appetite;
• malaise.

In severe cases, fever and dehydration may occur. If signs of enterocolitis appear, an urgent medical consultation is required. And no self-medications!

Dysbacteriosis after taking antibiotics: risk factors and solutions

Much more often there is a less aggressive consequence of treatment with antibacterial drugs - dysbiosis.

The likelihood of developing dysbiosis and, as a consequence, antibiotic-associated diarrhea increases if the primary infection is caused by Clostridia, Klebsiella, Staphylococcus aureus and some other pathogens.

In addition, the risk group for diarrhea associated with antibacterial drug treatment includes:

• elderly people;
• patients in inpatient departments;
• cancer patients;
• patients taking proton pump inhibitors

Recall that these drugs include drugs for the treatment of gastritis and peptic ulcer: Omeprazole, Lanzaprozole, Pantoprozole and others.

So, what should be done by those 5–39% of patients who, during or after taking antibacterial agents, felt the manifestations of dysbiosis?

First of all, do not lose heart. In the vast majority of cases, diarrhea is not the reason for discontinuation of essential drugs.

And secondly, at least one more drug will have to be added to the main drug list.

Our modernity is full of negative factors: an unfavorable environmental situation, stress, a sedentary lifestyle, chronic diseases, so it is difficult to imagine an adult who has never taken antibiotics in his life. They help us cope with serious infectious diseases, but they reward the consequences: dysbiosis, antibiotic-associated diarrhea, candidiasis. To avoid these problems, doctors recommend drinking probiotics and prebiotics during or after antibiotic therapy. These drugs correct the violation of the intestinal microflora, help restore the functions of the gastrointestinal tract.

Intestinal microflora

Why take probiotics and prebiotics while taking antibiotics

Against the background of uncontrolled long-term use of antibacterial drugs, death occurs and the reproduction of beneficial bacteria in the intestine is suppressed, and pathogens take their place. Probiotics are prescribed after antibiotics for adult patients to eliminate these effects.

Probiotics contain strains of bacteria (lactobacilli, bifidobacteria, and others) that:

• block the growth of the population of pathogens;
• increase the activity of enzymes involved in digestion;
• stimulate the immune system;
• have antiallergenic effect.

And prebiotics are preparations containing non-absorbable substances that support and stimulate the growth of the normal gut microbial landscape. Among them:

• lactic, citric, phosphoric acids;
• soy flour;
• active metabolites;
• oligo- and monosaccharides;
• dietary fiber necessary for the reproduction and settlement of beneficial bacteria.

Probiotics are creatures, and prebiotics are their food and environment. There are medicines containing both the first and the second. They are called synbiotics.

What are the benefits of lactobacilli

Probiotics often contain microorganisms of the genus Lactobacillus. These are immobile bacteria of an oblong or spherical shape, forming separate units or chains. They populate the human digestive system from the oral cavity to the rectum with the highest concentration in the large intestine.

Lactobacillus

Lactobacilli perform important functions in the intestines:

1. They produce peptidase enzymes that break down protein into structural units - amino acids, which are then absorbed into the human blood.
2. They participate in the processing of cholesterol, which means they prevent the formation of atherosclerotic plaques in the walls of blood vessels and reduce the risk of developing atherosclerotic disease.
3. They carry out the metabolism of lactose with the formation of lactic and acetic acids, which are distinguished by bactericidal properties. In the created acidic environment, the growth of pathogenic microorganisms is suppressed.
4. They activate the secretory function of the intestines with the production of digestive juices.
5. They affect the motility and movement of feces, contribute to the timely emptying of the intestines.
6. They stimulate local and general immune resistance of the body.
7. They have antitumor activity.

Functions of bifidobacteria

Bifidobacteria look like short rods with spherical thickenings, bifurcations at the end, which are located separately, in pairs, V-shaped, or in chains. They do not need oxygen for their vital functions, so they actively populate the human colon.

The following functions are beneficial for the human body:

1. The production of organic acids (acetic, lactic, succinic, formic), which regulate the normal pH of the intestine.
2. Synthesis of vitamins B1, B2, B6, B12, K, nicotinic and folic acid.
3. Improves the absorption of vitamin D, calcium, essential amino acids.
4. They regulate the composition of the normal flora, preventing the reproduction of pathogenic, putrefactive and gas-forming microorganisms.
5. Participate in the digestion of proteins, carbohydrates, fats, fiber.
6. They have antiallergic activity.
7. They form local immunity by influencing the intestinal lymphoid apparatus and the synthesis of immunoglobulins.

Bacteriophages

Some medicines contain bacteriophages. These are viruses capable of infecting highly specific pathogenic bacteria, multiplying inside them and leading to cell death. Bacteriophages are absolutely safe for humans, have no side effects and contraindications. But their significant disadvantage is activity against only one type of pathogenic microorganism, for example, against staphylococcus, Protea or Klebsiella.

Currently, polyvalent drugs are used that contain several bacteriophages at once, for example, Pyobacteriophage, Intestifag.

How to choose an effective and inexpensive drug

Pharmaceutical companies offer a wide range of probiotic drugs that can prevent the effects of antibacterial treatment. Each patient, depending on the severity of the manifestations of dysbiosis, the intensity and duration of therapy, financial capacity, can choose the appropriate medicine.

The effectiveness of the drug is determined by the number of active ingredients, the quality of raw materials and compliance with technical production standards.

Table of drugs with prices:

A drug	Composition	Act	Manufacturer	Price
Acipol	A mixture of acid-loving lactobacilli, kefir fungi	Suppression of pathogens and fungi	"Lecco"	From 400 rubles.
Bifiform	Bifidobacteria, enterococci	Probiotic, antidiarrheal effect	FERROSAN	From 496 rub.
Linex	Dried lacto-, bifidobacteria, lactic acid enterococcus	Complex probiotic	LEK PHARMACEUTICALS (Slovenia)	From 321 rub.
Normoflorin B or Normoflorin L	Live bifidobacteria or lactobacilli, amino acids, peptides, vitamins, lysozyme, organic acids, trace elements	Probiotic, by restoring the balance of bifidobacteria or lactobacilli. Prebiotic	Bifilux (Russia)	From 209 rub.
Hilak forte	Organic matter as a result of the life of lactobacilli, E. coli and fecal streptococcus	Prebiotic	Ratiopharm (Germany)	From 273 rub

Price is not an indicator of the effectiveness of a drug. Budget analogues have proven themselves well in the prevention of antibiotic-associated conditions and in the treatment of mild forms of microbial imbalance.

Table of cheap analogues:

Rules for the use of probiotics

Probiotics are living organisms, and in order for them to be safe and sound in their habitat - the large intestine, a number of rules must be observed:

1. You should not take an antibiotic and a probiotic at the same time to eliminate the negative effect of the former on the bacteria of the latter. It is necessary to maintain a break of at least 4 hours between taking these drugs.
2. The probiotic is taken orally 30-60 minutes before meals, from 1-2 times a day to 4 times, following the instructions.
3. Drink with liquid, the temperature of which does not exceed 37 ° C. Temperatures above this mark can cause the death of microorganisms.
4. To help bacteria overcome the acidic environment of the stomach, it is best to choose drugs in an acid-fast capsule. It will be delivered unchanged to the intestines, where it will ferment.
5. Preventive course of treatment from 5 days to 10 days. It is better to continue taking it for several days after the end of antibiotic therapy, since the medication will still circulate in the blood.

If, after antibiotic therapy, side effects have already developed in the form of diarrhea, flatulence, nausea, decreased performance and appetite, then the treatment course with probiotics is selected by the doctor individually, depending on the severity of the symptoms. On average, it lasts from 2 weeks to several months. You need to take the drug in the same way, according to the instructions, before meals 2-4 times a day.

Drinking probiotics for prophylaxis before a planned course of antibiotic therapy is recommended for patients with chronic diseases of the gastrointestinal tract:

• peptic ulcer;
• chronic enteritis;
• diverticular bowel disease;
• crohn's disease;
• nonspecific ulcerative colitis.

A short course of probiotics for 5-10 days will help avoid exacerbation and prolong the remission of the disease.

Natural probiotics and prebiotics

Probiotics have found widespread use in medicine, but it must be remembered that beneficial microorganisms are found in the products we are used to.

Against the background of antibacterial therapy, it is necessary to include in the diet sour milk (yogurt with natural sourdough, kefir, bifidok, soft cheeses, feta cheese, cottage cheese), pickled vegetables (cabbage, cucumbers). They contain beneficial lactobacilli and bifidobacteria, as well as vitamins B and K, necessary for their growth.

Dairy products

Foods rich in fiber and plant fibers (cabbage, vegetables, black bread, bran) support the normal functioning of intestinal bacteria, acting as prebiotic substrates.

Against the background of taking antibiotics, the growth of yeast fungi occurs, so it is necessary to eat onions, garlic, beets, pumpkin, coconut, grapefruit, which have antifungal activity.

Tea with ginger, peppermint, olive leaves inhibits the growth of pathogenic flora, normalizes intestinal peristalsis and stool, and reduces flatulence.

The natural prebiotic inulin, which promotes the growth of beneficial bacteria, is found in wheat, onions, bananas, garlic, asparagus, and artichoke.

The use of the listed products while taking antibiotics will help eliminate the adverse effects and avoid the development of dysbiosis, diarrhea and thrush.

Probiotics for antibacterial therapy in veterinary medicine

Animals, like humans, belong to the class of mammals, which means they have a similar structure and functioning of the digestive system. The use of antibiotics in veterinary medicine leads to the same adverse changes in the intestinal microbial landscape as in the human body.

For your pets, you can choose the same preparations containing lactobacilli, bifidobacteria, escherichia:

• bifidumbacterin;
• lactobacterin;
• bifidum forte;
• acipol;
• colibacterin.

The acidic environment of the gastrointestinal tract of animals makes it less susceptible to this group of drugs, therefore, preparations containing cultures of spore-forming bacteria Bacillus Subtilis and Bacillus Licheniformis (Bacillosporin, Vitasporin, Sporovit and others) have been developed. They have a pronounced activity against pathogenic and opportunistic microorganisms.

Today, an important topic is: what probiotics to drink when taking antibiotics, and which ones to take on a trip? Hint - the base is the same! \u003d)

I have a bad attitude towards antibiotics, especially when they are prescribed for any sneeze and for myself, but the situations are different.

And if the doctor prescribes medication, take probiotics while taking antibiotics needed from the first day! This is a rule of thumb to reduce the risk of side effects: diarrhea, thrush and the accumulation of allergies.

Probiotics accelerate the restoration of the original microflora, plus reduce the risk of antibiotic-associated diarrhea (AAD) and the colonization of pathogenic microflora in the place of useful one.

This is one of the most serious problems after a course of antibiotics - the appearance of clostridia. They cause intestinal inflammation, release a lot of toxins and are difficult to treat. You can avoid their appearance in one case - drink saccharomyces from the first day of therapy.

Probiotics when taking antibiotics

The main question is, which probiotics for antibiotics to choose?

Not all drugs are equally effective, and there are many strains for different situations.

When treating with antibiotics, the joint intake of the fungi of the saccharomycetes Boulardi Saccharomyces boulardii and the lactobacillus Lactobacillus rhamnosus GG showed the greatest efficiency.

I will explain why. Saccharomycetes are the most effective probiotics against acute diarrhea in children and adults. They do not take root in the intestinal tract, and completely withdrawn after a few days! During this time, they do a great job and displace the pathogenic flora that populates at the site of the destruction of beneficial bacteria.

Saccharomycetes also strengthen the epithelium of the intestinal walls (leaky gut syndrome) and prepare the ground for the establishment of beneficial microflora, which we colonize with lactobacilli.

Where to find Boulardi saccharomyces

IHerb has one option, Saccharomyces Jarrow Formulas, Saccharomyces Boulardii, they are already with a prebiotic.

The second probiotic required is the lactobacillus Lactobacillus rhamnosus GG, we find them here Culturelle with inulin.

I like capsules, there are chewable tablets for children, and for very little ones probiotic droplets.

The second "fallback" option, instead of LGG, take the acidophilic bacteria Lactobacillus acidophilus, they are part of Pro-Biotic Acidophilus and acidophilic pearls of Probiotic Pearls.

How to take probiotics?

Probiotics start drinking with antibiotics from the first day of treatmentand continue for another 7 days after taking the last dose of the antibiotic.

The best time to take in beneficial bacteria is with breakfast. Boulardi saccharomyces can be drunk at the same time as an antibiotic, since they are fungi, they are resistant to the effects of the drug.

Other probiotics are best drunk 2 hours after taking the antibiotic, this applies to LGG and lactobacillus acidophilus.

Travel Probiotics

Fungi Saccharomycetes come in handy when traveling. If you are going on a tripalso take along yeast Saccharomyces boulardii and / or Bifidobacterium longum .

Boulardi's saccharomyces are the most effective probiotics against acute diarrhea in adults and children, provoked by antibiotics or pathogens during travel (salmonella, staphylococcus, E. coli).

Studies have shown that taking 500 mg (10 billion) of S. boulardii per day significantly reduces the risk of "traveler's diarrhea" and also reduces the sequelae if the infection is caught.

Where to find: I love this option for travel Jarrow Formulas, Saccharomyces Boulardii + MOS

Bifidobacterium longum BB536

Second Travel Probiotic Registered Strain Bifidobacterium longum BB536... It is the most popular probiotic in Japan, used in supplements and in yoghurt.

It supports healthy gut microflora in children and adults, improves the quality of life in polluted metropolitan areas and helps to adapt to unfamiliar food.

The strain has more than 50 clinical trials and is also beneficial for:

- reduces the incidence of influenza in the elderly over 65

- reduces the manifestations of seasonal allergies and the number of eosinophils in the blood, when taken one month before the start of the season

- lowers cholesterol (effect after 9 weeks of administration)

— strengthens bones in osteoporosis along with calcified milk (probiotic improves gut health, resulting in lower pH levels and better calcium absorption), see diagram:

Where to find: Bifidobacterium longum BB536 in Natural Factors Probiotic, TravelBiotic

In summary, probiotics when taking antibiotics you need to drink from the first day, and it is imperative to include Saccharomycetes fungi in the scheme.

Also here I wrote about, and here how to choose for the desired task

Using code IFO971 with every order, you help me maintain my blog and write reviews on purchases. The code is entered manually, already at checkout. I am grateful for using it!

Want more information on probiotics and new strains? Let me know in the comments \u003d)

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• July 29, 2017 / 13:20

  • July 31, 2017 / 18:56

    July 31, 2017 / 23:36

The discovery of antibiotics in the middle of the last century provided new possibilities in the treatment of infections caused by various microorganisms. The term "antibiotic" itself means "against life." Against the life of pathogenic, disease-causing microbes. At that time, medical science did not know much about the fact that beneficial microorganisms also live in the human body, although at the beginning of the century the Russian physiologist Ilya Mechnikov published his findings on the health benefits and life expectancy of lactic acid bacteria. Alas, antibiotics turned out to be directed against the life of beneficial microorganisms too.

Uncontrolled use has led to the creation of more and more generations of antibiotics due to the development of resistance by microbes to them, intolerance by some people of some of them, allergic reactions and disturbances of the microbial flora in the intestine in the form of a disorder of stool and other organs (for example, vaginal candidiasis after taking antibiotics tetracycline group).

Scientists wondered how to preserve the beneficial flora against the background of the use of antibiotic therapy, how to quickly eliminate dysbiosis after antibiotics. The result was the creation of drugs based on beneficial microorganisms that colonize the intestinal tube. In 1965, it was named. In contrast to antibiotics, they were called "probiotics", which means "in the interests of life." The main purpose is to restore normal microflora, especially after taking antibiotics.

Classification

Probiotics are live microorganisms that are introduced into food or medicine. The most useful are recognized lacto- and bifidobacteria, saccharomycete fungi and varieties of Escherichia coli.

The value of probiotics boils down to the following:

• Strengthening immunity due to the production of antibodies against certain viruses.
• Secretion of biologically active substances that prevent inflammation.
• Prevents pathogenic bacteria from attaching to the intestinal wall.
• Strengthening the barrier function of the intestinal mucosa.
• Antitoxic effect against waste products of pathogenic microbes.
• The production of B vitamins.

Research on the role of probiotics continues. The specificity of the action of each type is investigated for a specific problem, and adequate dosages are selected. Methods of "delivering" probiotics to the intestine are also contemplated to keep them from being destroyed by the acidic environment of the stomach.

It should be noted that the beneficial microflora that lives in the intestines is very sensitive to various influences, including stress.

When antibiotics are taken, beneficial microbacteria also die, and since nature abhors a vacuum, the pathogenic bacteria Clostridium comes in their place, causing antibiotic-associated diarrhea. That is why, when taking antibiotics, it is urgent to populate new probiotics instead of the dead.

The arsenal of probiotics available today is vast. It is worth getting to know him better.

1st generation probiotics

If we consider the classification by the number of bacterial strains in the preparation, then the division goes into monocomponent, multicomponent, combined, and recombinant. 1st generation probiotics are drugs that contain only one type of bacteria:

• Bifidumbacterin.
• Lactobacterin.
• Colibacterin.

Let's look at each of these drugs, looking at how to take them in combination with an antibiotic.

Colibacterin

It is a dry powder (lyophysate) containing live strains of E. coli and a growing medium in the form of propolis, soy extract. The powder must be dissolved in a small amount of liquid (water, juice, vegetable broth, compote) and drunk on an empty stomach three times a day. The course of treatment ranges from 1 to 3 months - its duration is determined by the doctor.

Colibacterin will help reduce the side effects of antibiotics and stop diarrhea that occurs.

In some cases, it is permissible to use drugs in the form of rectal microclysters. Colibacterin can be prescribed for children from infancy in adequate dosages.

The price of the drug ranges from 200-300 rubles for 10 ampoules or vials containing 3 doses.

Lactobacterin

Contains live acidophilic lactobacilli. Available in 3 dosage forms:

• Powder from which a suspension is prepared for drinking and topical use.
• Tablets.
• Vaginal suppositories.

The powder is dissolved in water at the rate of 1 tsp. for 1 dose (usually 5 doses in a bottle). The amount per visit and the frequency will be prescribed by the doctor. The course is individual - from 3 to 6 weeks. Admitted to children under 1 year old.

There is some peculiarity of how to take Lactobacterin correctly in the treatment of colpitis. In this case, it is not recommended to introduce probiotics with antibiotics, since Lactobacterin suppositories can weaken the effect of the antibiotic on the pathogenic flora. It will be more effective to conduct a course of Lactobacterin after the end of the main therapy.

The price of Lactobacterin is 150–250 rubles.

Bifidumbacterin

Contains dried live bifidobacteria normalizing intestinal microflora and excipients. Available in foil sachets from 10 to 30 pieces per pack, vaginal suppositories (10 pieces), tablets (30 pieces).

Designed to enhance the immune status and restore the intestinal and vaginal microflora, improve digestion, treat diarrhea, and strengthen resistance to artificially fed children.

Take with food, after dissolving the contents of the package with boiled water. Can be dissolved in kefir, yogurt. The frequency of reception depends on the indications and ranges from 1 to 6 times. The courses are also varied in duration - from 5–8 days for acute intestinal infection to 6 months for the prevention of acute intestinal infections.

The simultaneous administration of Bifidumbacterin and an antibiotic is allowed with a time gap of at least 2 hours.

The price is within 100 rubles.

2nd generation probiotics

They are also called self-eliminating antagonists, that is, spore-forming. Bacteria only temporarily colonize the gastrointestinal tract. They effectively resist pathogenic and opportunistic bacteria, normalize the intestinal microflora.

Sporobacterin

Bacillus subtilis strain 534 in the form of lyophilized biomass or hay bacillus spore - this is the active substance of the Sporobacterin preparation, aimed at eliminating loose stools and strengthening the immune system. It is produced in the form of a 10 ml dropper bottle based on a 7% sodium chloride solution, which explains the salty taste of the drug taken on an empty stomach.

The amount for 1 dose is 0.5 ml for children under 3 years old, then - 1 ml in the morning and evening. The course of admission is from 10 to 20 days.

Price - 300-500 rubles.

Biosporin

Unlike Sporobacterin, the composition contains, in addition to the spores of the hay bacillus, live bacteria bacillus licheniformis.

It is produced in the form of tablets of 1 or 2 doses in an amount of 10, 20 and 30 pieces in a package and in the form of a lyophilisate for preparing a suspension of 1, 2, 5 and 10 doses.

The indications are similar to the previous drugs. Reception of Biosporin is carried out on an empty stomach, adults - 2 doses, children - 1 dose. Before use, it is recommended to dilute with water in the amount of 5 ml per 1 dose. Assign 2-3 times a day, the course for acute infection within a week, with dysbiosis - up to 2 weeks.

Locally, intravaginally, a tampon moistened with suspension is placed for 2-3 hours, the course is 5-7 days. Colpitis treatment is carried out after the end of the course of antibiotics.

The price is within 500 rubles. Produced in Ukraine.

Bactisubtil

Gelatin capsules containing spores of bacillus cereus and excipients. Packed in blisters of 20 pieces. Having common indications with other probiotics, it is contraindicated in primary immunodeficiency and in preschool children.

Usually 1–2 doses are prescribed 2–4 times a day on an empty stomach for 7–10 days. You can not drink hot drinks and alcohol during treatment.

The drug is dispensed by prescription. Produced by the French company Sanofi. The price in Russia is within 1000 rubles.

Flovins BS

Antidiarrheal and microflora normalizing agent containing dry spores of the bacillus Cereus. Available in capsules, which are taken on an empty stomach from 1 to 4 pieces a day, 2-4 times a day for 7-10 days. The same precautions apply for hot drinks and alcohol. Allowed to be taken simultaneously with antibiotics.

Product of the Republic of Montenegro.

Enterol

Biocodex (France) offers a probiotic based on lyophilized saccharomycete, packaged in 250 mg sachets of 10, 20 and 30 or 250 mg capsules in vials of 30 and 50 pieces.

A feature of the drug is that Saccharomycetes are not part of the beneficial microflora, which means that after passing through the digestive tract, it is excreted from the body 2–5 days after the end of the intake. Question: "Why then take probiotics based on saccharomycetes?" - has a clear answer. The wall of the saccharomycete has the ability to attach to itself pathogenic microorganisms that disrupt the gastrointestinal tract and cause diarrhea. Thus, he leaves the human body not alone, but taking pathogenic microbes with him.

Lack of lactase, lactose intolerance, malabsorption syndrome are contraindications for admission.

Adults drink 1 capsule or powder 2 times a day for no more than 10 days, for children from 1 to 3 years old, the powder is diluted in their favorite drink and given on an empty stomach. Combination with antifungal antibiotics is not recommended.

The price is from 300 to 700 rubles.

Each package of probiotics must contain a leaflet with instructions on how to take the drug. You need to familiarize yourself with it first of all in order to avoid negative consequences. But at the same time, you should adhere to the course of treatment (dosage, duration), which was prescribed by the doctor.

3rd generation probiotics

Unlike the drugs of the first two generations, these are multicomponent, that is, they simultaneously contain several strains of bacteria. Some of them have been added with special additives, the task of which is to enhance the growth of beneficial flora in the intestines.

It is customary to refer to probiotics of the 3rd generation:

• Acipol.
• Linex.
• Acylact.
• Bifiform.
• Bifilis.
• Acidolac.
• Enterogermina.

Let's take a closer look at what bacteria are contained in each of these drugs, as well as how to take a probiotic, and how to combine it with antibiotics.

Acipol

The drug in capsules contains live lactobacilli in combination with the polysaccharide of the kefir fungus. This composition is freeze-dried. Packaged in 10, 20 and 30 capsules in boxes or jars. The main indication for use is dysbiosis and situations leading to it, as well as AEI.

After 3 months, the drug is dissolved in water or milk, children over 3 years old are given a whole capsule to drink. The frequency of admission in children is 2-3 times with meals, in adults - up to 4 times on an empty stomach. With OCI, take 5-8 days, approximately the same course is necessary for the treatment of dysbiosis.

Simultaneous treatment with an antibiotic is possible, but separation in time is desirable within 2 hours.

It is dispensed without a prescription and costs about 350 rubles.

Linex

Consists of 3 main components:

• Lactobacillus.
• Bifidobacterium infantum.
• Enterococci.

Of course, all living things are dried in a special way. Release form - sachets of 10 and 20 pieces, capsules of 16, 32 and 48 pieces and drops for babies 8 ml in a bottle.

The drug is given after meals, the dosage depends on the age and severity of the disease. The instruction suggests the use of 1-2 capsules 3 times a day. The duration of treatment is strictly individual. Combines with taking antibiotics.

Manufacturer Sandoz, Switzerland. Price - 300-400 rubles.

Acylact

Lactobacillus in the form of a lyophilisate. Live dried bacteria are offered in 2 dosage forms - suppositories and tablets. Tablets have found their application in dentistry, gastroenterology, vaginal suppositories complete the stage of treatment of vaginosis and vaginitis in gynecology.

The tablets are prescribed after meals, the course for acute pathology is 7 days, chronicles require a 14-21-day course, which is repeated up to 3 times a year with an interval of at least a month. You can combine the reception with an antibiotic, but not in the case of gynecology. With severe stomatitis, the course is up to 15 days, the course must be repeated 3 times, the interval is a week. The tablets should be sucked in the mouth.

The price is pleasantly surprising - 10 tablets or candles for 150 rubles.

Bifiform

The Italian pharmaceutical company Pfizer and Ferrosan (Denmark) offer enteric-coated capsules containing Enterococcus and Bifidobacteria. The capsules are packed in boxes of 20, 30, 40 and 60 pieces.

Live bacteria are the natural flora of the human intestine. They are antagonists of pathogenic and opportunistic flora, and also indirectly have a positive effect by stimulating the production of immunoglobulin A, interferon. The probiotic is effective in antibiotic-associated diarrhea, acute intestinal infections, travelers' diarrhea, dysbiosis, in the complex therapy of H. pylori infection.

Acute diarrhea requires 4-fold intake of 1 capsule until the diarrhea stops, then 2-3 capsules a day to consolidate the effect. Children are prescribed from 2 years old, dosages are individual. You do not have to ask your doctor how to take probiotics and antibiotics, because the simultaneous intake is allowed.

The price for 30 capsules is 400–500 rubles.

Bifilis

Bifidobacteria combined with lysozyme - this is the composition of Bifilis powder and suppositories. Suppositories are available in the form of rectal and vaginal, lyophilisate is in vials. The drug is diluted with water and taken before meals 30 minutes. Before the introduction of the rectal suppository, a cleansing enema is recommended, and before the vaginal one - vaginal hygiene.

The standard dosage - 2-3 vials per day - may vary depending on indications and age. The simultaneous appointment of suppositories and suspensions is permissible. It is allowed to conduct a simultaneous course with antibiotics.

The price is 400–450 rubles.

Acidolac

Powder for oral solution contains lacto and bifidobacteria. The contents of the sachet must be completely dissolved in boiled water (not boiling water, but at room temperature), warm tea, yogurt or milk. It is taken with meals.

Dosage for dysbiosis: child 2-12 years old - 1-2 sachets 1 or 2 times a day, adults - 2-3 sachets 2 or 3 times a day. The same dosages are prescribed for the treatment of diarrhea. Only in the first case, the course of therapy lasts a week or 2 weeks, in the second - 10 days.

The price for 10 sachets averages 930 rubles.

Enterogermina

Available in several forms: oral suspension (10 or 20 vials of 5 ml), capsules (12 pieces in a blister).

The drug in vials is recommended to be used according to the following scheme: a child from 1 month to 18 years old - 1 bottle 1 or 2 times a day, an adult - 1 bottle, but 2 or 3 times a day. The duration of treatment is determined by the doctor, based on the patient's condition. Accepted at regular intervals. To do this, shake the bottle and drink it undiluted or add to water, milk, tea, juice.

Enterojermina capsules are prescribed for adults and children over 5 years old. The drug must be swallowed whole with water. If it doesn't work out, you need to buy a suspension. A child is recommended 1-2 capsules per day, an adult - 2-3 capsules. The course of treatment is selected individually

Enterogermina does not interact with antibiotics, so it can be prescribed simultaneously with the course of antibiotic therapy. But the combined use of the two means is contraindicated - you need a break of 2-3 hours.

Any probiotic has a number of contraindications (this list is insignificant), so the drug must first be agreed with a doctor. Also, one cannot deviate from the course of treatment prescribed by the specialist.

4th generation probiotics

These are preparations that contain live bacteria immobilized on a sorbent. This group included several types of sorbed bifid-containing preparations:

• Probiform.
• Florin Forte.
• Bifidumbacterin Forte.

Probiform

Bifidobacteria adsorbed on activated carbon. Available in powder and capsule form. The powder is diluted in water or fermented milk product. The maximum allowed to take up to 6 powders or capsules with a short interval, the course - 2-3 days (this scheme is recommended for acute diarrhea, dysbiosis requires an increase in the course up to 10 days).

Powders are available in 6, 10 and 30 pieces, capsules in 10.

The price for 30 powders is 1900 rubles.

Florin Forte

Capsules and powder with live bifidobacteria and lactobacilli, reinforced with activated carbon. The effect of the drug is enhanced when taken with B vitamins. When taken during the course of antibiotics, the time of separation should be at least 3-4 hours. It should be taken during or regardless of food intake, it is better to combine it with kefir and other fermented milk product.

The course with OCI is 5–7 days, with dysbiosis it is lengthened by 2 times.

Florin Forte can be prescribed even to premature babies in the dosage recommended by the doctor.

You can buy it for 600 rubles for 30 capsules or powders.

Bifidumbacterin Forte

Powder from live bifidobacteria, precipitated on particles of activated carbon and lactose. Release form - powder in sachets of 5 doses in a total of 10 or 30 and capsules.

This probiotic is recommended to be taken with or without food, dissolving in water or fermented milk product. The course of treatment is determined by the nature and severity of the disease, but it can be administered even to premature babies. One-time reception - 1-2 sachets, depending on age. The courses are recommended to be repeated up to 2-3 times.

B vitamins enhance the effect of the probiotic, but the simultaneous administration with the antibiotic reduces the effect.

The price for 10 sachets or capsules is 150–180 rubles.

There is no doubt that taking antibiotics should be accompanied by taking probiotics. The question is how to take probiotics with antibiotics - at the same time or after the end of the course of antibiotic therapy.

When choosing an answer, it should be borne in mind that probiotics with an acid-resistant capsule containing lacto-, bifidobacteria and streptomycetes are more suitable for simultaneous administration.

Which probiotics should be taken along with antibiotics, and which should not:

• Parallel administration of Linex, Bifiform well reduces the side effects of antibiotics on the beneficial intestinal microflora.
• Enterol is best prescribed after a course of antibiotic therapy.
• Some probiotics have been studied in light of interactions with specific antibacterial drugs. For example, it is known that Bificol is combined with rifampicin, and Linex with ampicillin, Bactisubtil - with chloramphenicol and Biseptol, Lactobacterin - with Doxycycline and Negram.

In general, it is worth noting that the study of this group of drugs continues, and, possibly, results will be obtained that open new horizons in the fight against infections.

As for today's problems, it is important to remember that any time antibiotic drug therapy is taken before or after it, and possibly both, it is necessary to restore beneficial microflora with probiotics. The doctor will recommend the correct treatment regimen, individual dosages. The patient's task is to accurately follow the doctor's recommendations, and then a healthy intestinal microflora will effectively maintain the entire body in normal condition.

In many cases, antibiotic treatment is very important, as it helps to successfully eliminate dangerous microorganisms from the child's body. However, these drugs have a certain list of side effects. One of them is dysbiosis, since antibacterial agents do not distinguish between beneficial intestinal bacteria and harmful microbes at the site of inflammation. They equally inhibit all microorganisms, as a result of which in 5-40% of cases of antibiotic treatment in children, disorders of the digestive system appear. This is the reason for the appointment of probiotics.

How do they work?

Probiotic group preparations used in antibiotic therapy:

• They resist pathogenic and opportunistic bacteria, colonizing the intestines of the child.
• Participate in the production of vitamin K, folic acid, biotin and other nutrients.
• Strengthen local immunity, and also generally stimulate the immune system.
• They help to quickly eliminate allergic reactions to antibiotics.

Proof of effectiveness

In recent years, a large number of studies have been conducted on the effects of probiotics on the intestinal flora. For example, in 2002, a large study was conducted that collected the results of 9 surveys. They involved people who were treated with antibiotics.

One group of volunteers was given an additional probiotic, and the other was given a placebo (a fake drug with no effect disguised as a probiotic). A meta-analysis confirmed that probiotics are indeed effective for antibiotic-induced diarrhea.

Why are probiotics better than fermented milk products?

The fermented milk products sold in our stores contain mainly lactobacilli. Their resistance is not as high as that of the strains of microorganisms included in modern probiotic preparations. It is important not only to ensure that valuable bacteria enter the digestive tract, but also their survival in the intestines.

That is why it is not worth replacing probiotic treatment with the use of kefir and other fermented milk products, however, replenishing the diet with such products will be a good support for taking probiotics in the form of medicines. Give your child yogurt, kefir, fermented baked milk and other fermented milk products every day before bed. Read more about such products in the article on prebiotics.

When are they taken?

A probiotic is often prescribed simultaneously with taking an antibiotic, since under the influence of an antimicrobial drug, beneficial microorganisms are destroyed along with pathogens, and drugs with a probiotic effect replenish the amount of bacteria valuable for our intestines. Such an appointment will not give a chance to the growth of opportunistic and pathogenic bacteria in the place of destroyed lactobacilli and other representatives of the intestinal flora.

Also, quite often, a probiotic is prescribed to children immediately after treatment with antibiotics in order to increase local and general immunity, eliminate allergic reactions that have appeared and normalize digestive function.

Admission rules

• Depending on the drug, the probiotic can be taken 1 to 6 times a day with meals.
• Preparations of the probiotic group should not be washed down with any hot drink, since at temperatures above +45 degrees, the vital activity of the bacteria contained in them is disrupted.
• The duration of the intake of probiotics should be selected individually. Prophylactically, they can be prescribed only for the time of taking antibiotics, and when diarrhea appears, treatment will be longer (sometimes even several months).
• Capsule preparations for small children are opened, and their contents, divided into parts, are added to non-hot liquid or other food. At the same time, the diluted drug cannot be stored.
• It is important for parents to monitor the expiration dates of the purchased probiotic, since after its completion, the drug will no longer contain the required number of bacteria.
• At the same time, it is worth adjusting the diet of the crumbs. During the period of illness and recovery, the baby should not be given dishes that will become a great burden on his body, for example, fatty foods. Make sure your child is eating enough fiber-rich foods to support the growth of beneficial microorganisms in the intestines.