Adding Probiotics to Antibiotic Interventions May Reduce Gut Microbiome Impact

The addition of probiotics to antibiotic interventions may improve gut microbial composition and preserve alpha diversity, which can be adversely impacted from antibiotic use, according to the results of a recent systematic review.1

The researchers utilized the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to search various databases for related articles from January to December 2021. A total of 29 articles were included.

Inclusion criteria required all articles to be randomized clinical trials on the effects of antibiotics alone (n = 11), probiotics alone (n = 11), or antibiotics and probiotics together (n = 7). Additionally, all articles must include 16S rRNA, have adult participants, and be in English.

The results indicated that co-administering probiotics with antibiotics may prevent some of the gut microbiome changes which are commonly observed in patients receiving antibiotics. In addition, the use of probiotics may restore health-related bacteria to the gut microbiome, including Faecalibacterium prausnitzii.

However, the researchers note that a lack of standardization for gut microbiome analysis and the wide range of selected antibiotics and probiotics used across these studies are limitations to this review. 

“When participants take antibiotics, we see several consistent changes in some bacterial species. But when treatment was combined with probiotics, the majority of those changes were less pronounced and some changes were completely prevented,” the researchers concluded in a press release.2 “Considering the human data available up to this point, there does not seem to be a reason to withhold a prescription of probiotics when antibiotics are prescribed.”


—Leigh Precopio



  1. Fernández-Alonso M, Camorlinga AA, Messiah SE, Marroquin E. Effect of adding probiotics to an antibiotic intervention on the human gut microbial diversity and composition: a systematic review. J Med Microbiol. Published online November 16, 2022.
  2. Take probiotics alongside your prescribed antibiotics to reduce damage to your gut microbiome, says the first review of the data. News release. Microbiology Society; November 16, 2022. Accessed December 2, 2022.