Antibiotics are used to either kill or slow down the growth of bacteria and are divided
into the categories listed below.
Summary of
Interactions with Vitamins, Herbs, and Foods
In some cases, an herb or supplement may appear in more than one category, which may seem
contradictory. For clarification, read the full article for details about the summarized
interactions.
May Be Beneficial:Depletion or
interference—The medication may deplete or interfere with the absorption or
function of the nutrient. Taking these nutrients may help replenish them.
Vitamin K
May Be Beneficial:Side effect
reduction/prevention—Taking these supplements may help reduce the likelihood and/or
severity of a potential side effect caused by the medication.
Bifidobacterium longum
Lactobacillus acidophilus
Lactobacillus casei
Saccharomyces boulardii
Saccharomyces cerevisiae
Vitamin K
May Be Beneficial:Supportive
interaction—Taking these supplements may support or otherwise help your medication
work better.
Saccharomyces boulardii
Reduced drug
absorption/bioavailability
None known
Adverse interaction
None known
Interactions common to many, if not all,
Antibiotics are described in this article. Interactions reported for only one or several drugs
in this class may not be listed in this article. Some drugs listed in this article are linked
to articles specific to that respective drug; please refer to those individual drug articles.
The information in this article may not necessarily apply to drugs in this class for which no
separate article exists. If you are taking an Antibiotic for which no separate article exists,
talk with your doctor or pharmacist.
An asterisk (*) next to an item in the summary indicates that the
interaction is supported only by weak, fragmentary, and/or contradictory scientific
evidence.
Interactions common to most, if not all, antibiotics are described in this article. For
interactions involving a specific antibiotic refer to the highlighted drugs listed below.
Probiotics
A common side effect of antibiotics is
diarrhea, which may be caused by the elimination of beneficial bacteria normally found in
the colon. Controlled studies have shown that taking probiotic microorganisms—such as
Lactobacillus casei, Lactobacillus acidophilus, Bifidobacterium
longum, or Saccharomyces boulardii—helps prevent antibiotic-induced
diarrhea.1
The diarrhea experienced by some people who take antibiotics also might be due to an
overgrowth of the bacterium Clostridium difficile, which causes a disease known as
pseudomembranous colitis. Controlled studies have shown that supplementation with harmless
yeast—such as Saccharomyces boulardii2 or Saccharomyces
cerevisiae (baker’s or brewer’s yeast)3 —helps prevent
recurrence of this infection. In one study, taking 500 mg of Saccharomyces boulardii
twice daily enhanced the effectiveness of the antibiotic vancomycin in preventing recurrent
clostridium infection.4 Therefore, people taking antibiotics who later develop
diarrhea might benefit from supplementing with saccharomyces organisms.
Treatment with antibiotics also commonly leads to an overgrowth of yeast (Candida
albicans) in the vagina (candida
vaginitis) and the intestines (sometimes referred to as “dysbiosis”).
Controlled studies have shown that Lactobacillus acidophilus might prevent candida
vaginitis.5
Vitamin
K
Several cases of excessive bleeding have been reported in people who take
antibiotics.6789 This side effect may be the
result of reduced vitamin K activity and/or reduced vitamin K production by bacteria in the
colon. One study showed that people who had taken broad-spectrum antibiotics had lower liver
concentrations of vitamin K2 (menaquinone), though vitamin K1 (phylloquinone) levels remained
normal.10 Several antibiotics appear to exert a strong effect on vitamin K
activity, while others may not have any effect. Therefore, one should refer to a specific
antibiotic for information on whether it interacts with vitamin K. Doctors of natural medicine
sometimes recommend vitamin K supplementation to people taking antibiotics. Aditional research
is needed to determine whether the amount of vitamin K1 found in some multivitamins is
sufficient to prevent antibiotic-induced bleeding. Moreover, most multivitamins do not contain
vitamin K.
References (To view, roll mouse over the "References" heading; to hide, click on the heading)
1. Elmer GW, Surawicz CM, McFarland LV. Biotherapeutic agents. A
neglected modality for the treatment and prevention of selected intestinal and vaginal
infections. JAMA 1996;275:870–6 [review].
2. Elmer GW, Surawicz CM, McFarland LV. Biotherapeutic agents. A
neglected modality for the treatment and prevention of selected intestinal and vaginal
infections. JAMA 1996;275:870–6 [review].
3. Schellenberg D, Bonington A, Champion CM, et al. Treatment of
Clostridium difficile diarrhoea with brewer’s yeast. Lancet
1994;343:171–2.
4. Surawicz CM, Elmer GW, Speelman P, et al. Prevention of
antibiotic-associated diarrhea by Saccharomyces boulardii: A prospective study.
Gastroenterol 1989;96:981–8.
5. Elmer GW, Surawicz CM, McFarland LV. Biotherapeutic agents. A
neglected modality for the treatment and prevention of selected intestinal and vaginal
infections. JAMA 1996;275:870–6 [review].
6. Suzuki K, Fukushima T, Meguro K, et al. Intracranial hemorrhage in an
infant owing to vitamin K deficiency despite prophylaxis. Childs Nerv Syst
1999;15:292–4.
7. Huilgol VR, Markus SL, Vakil NB. Antibiotic-induced iatrogenic
hemobilia. Am J Gastroenterol 1997;92:706–7.
8. Bandrowsky T, Vorono AA, Borris TJ, Marcantoni HW. Amoxicllin-related
postextraction bleeding in an anticoagulated patient with tranexamic acid rinses. Oral
Surg Oral Med Oral Pathol Oral Radiol Endod 1996;82:610–2.
9. Kaiser CW, McAuliffe JD, Barth RJ, Lynch JA. Hypoprothrombinemia and
hemorrhage in a surgical patient treated with cefotetan. Arch Surg
1991;126:524–5.
10. Conly J, Stein K. Reduction of vitamin K2 concentration in human
liver associated with the use of broad spectrum antimicrobials. Clin Invest Med
1994;17:531–9.
The information presented in Aisle7 is for informational purposes only.
It is based on scientific studies (human, animal, or in vitro), clinical experience,
or traditional usage as cited in each article. The results reported may not necessarily occur
in all individuals. For many of the conditions discussed, treatment with prescription or over
the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist
for any health problem and before using any supplements or before making any changes in
prescribed medications.
