Gut Resilience During Antibiotics (AAD prevention)
Adults/kids using systemic antibiotics (consult pediatrician for children).
gut
antibiotics
probiotics
reduce risk of antibiotic-associated diarrhea (AAD)
Core stack
Saccharomyces boulardii CNCM I-745
A
Dose: 250–500 mg twice daily (or 5–10 billion CFU/day)
Start within 24 h of first antibiotic dose; continue through course and 3–7 days after
Antibiotic course + short tail
Why: Consistent evidence for reducing AAD risk in adults and children.
Cautions
- Avoid in immunocompromised or central line patients (rare fungemia)
Lactobacillus rhamnosus GG (ATCC 53103)
A (pediatrics), B (adults)
Dose: 10–20 billion CFU/day
Separate from antibiotics by ≥2–3 h
Antibiotic course + 3–7 days
Why: Reduces risk/duration of AAD in multiple trials.
Sources
Not recommended
- Unspecified ‘multi-strain’ probiotics without documented strains/doses: Strain-specific effects; lack of evidence for generic blends.
Monitoring
- Stool frequency/consistency
- Signs of C. difficile—seek care if severe