Can Probiotics Help Reduce Antibiotic Resistance?

Written by: Kari Raman, PharmD, RPh
Published July 9, 2023

The question if probiotics can help reduce antibiotic resistance isn’t one I get asked at the pharmacy, but when I’m hanging out with other pharmacists, it is a topic we sometimes discuss. The short and up-front answer is unknown at this point, but it is an interesting topic to dive into. There are some studies that have been attempted to prove this theory, but I have not found any promising research that supports this claim. However, I have found some interesting hypotheses that theoretically may show promise in further research.

As I have mentioned throughout my blog, probiotics are microorganisms that can provide health benefits in several different ways. They are mostly known for their benefits in the gut and with digestion amongst other ailments. I have found some interesting articles that suggest probiotics may help reduce antibiotic resistance.  Currently their role in helping to reduce antibiotic resistance is still debatable, there are studies and research being conducted to determine if probiotics may play a role in decreasing antibiotic resistance. This topic really caught my attention because I know that antibiotic resistance is a growing problem throughout the world.

What is Antibiotic Resistance?

In the pharmacy I see antibiotic resistance pretty often. Usually what happens is a patient comes in to treat an infection with an antibiotic, then comes back two weeks later with another prescription for different medicine to treat the same infection. This is a growing problem and is definitely something to take a closer look at. 

Antibiotic resistance happens when bacteria mutate and develop the ability to survive and multiply in the presence of antibacterial medicines, causing the drugs to be ineffective. What basically happens in this situation is that, when you take an antibiotic that has historically fought off a certain infection, it no longer works. The bacteria have become resistant, and the drugs have become ineffective at treating the infection. This is a significant global health concern. The most common causes for antibiotic resistance are misuse, overuse, and genetic mutations in bacteria. The treatment results from antibiotic resistance are reduced treatment options, increased healthcare costs, and higher mortality rates. The population’s overexposure to antibiotics creates opportunities for better survival and an increase of antibiotic resistant bacteria.

Attempting to decrease antibiotic resistance will include implementing the responsible use of antibiotics for treating infections, prevention of infections, and increased awareness and education on the proper use of antibiotics. In addition to these efforts, some researchers have begun to investigate the possibility of probiotics aiding in the fight to decrease antibiotic resistance. So far, I have not found many really strong studies to support this claim, but I think it is an interesting possibility for the future.

How Can Probiotics Play a Role in Possibly Decreasing Antibiotic Resistance?

Three ways that are being considered for probiotics to be possibly beneficial in helping to combating antibiotic resistance are:

  1. It is thought that probiotics can compete with harmful bacteria for resources and space in the gut. Through competitive exclusion the good bacteria in probiotics can establish themselves and thrive in the gut, limiting the growth of the antibiotic resistant bacteria.
  2. Another possible way for probiotics to possibly help fight antibiotic resistance is to change the gut flora by diversifying the type of microorganisms in the GI tract. A balanced and diverse gut flora is important for overall health. By restoring or maintaining a healthy and balanced gut, probiotics may help prevent the overgrowth of antibiotic resistance bacteria.
  3. The third possible way that probiotics may help combat antibiotic resistant bacteria is with the substances the probiotics produce in the GI tract. As I have discussed in some of my other posts, some probiotics produce organic acids, these organic acids may have beneficial effects against antibiotic resistant and other bad bacteria.

It is important to realize that these are some interesting ways that probiotics may help in the fight against antibiotic resistance, but this topic is still at the very early stages of research. There is very little research if any that shows probiotics help fight against antibiotic resistance. With this said, I still think it is an interesting topic, and I will be looking out for more research about the relationship between probiotics and antibiotic resistant bacteria in the future.

What are Things to Consider Regarding Probiotics Potentially Helping to Reduce Antibiotic Resistance?

Similar to the other possible benefits of probiotics that I have discussed in my blog, several things that we should consider regarding probiotics potentially helping to reduce antibiotic resistance are:

  1. The strain of the probiotic and the effect that strain has on the gut microbiota. Something that may be considered when looking at a probiotic’s ability to assist with combating antibiotic resistance is the compatibility in the GI tract with each type of target bacteria.
  2. The timing and dosing should also be considered. The timing of consuming the probiotic in relation to the antibiotic is also something to consider, as well as the dose of the probiotic. These factors require further investigation.
  3. A third area of research that may be considered is targeted use. Probiotics may be more effective in certain types of antibiotic resistant infections or in certain patient populations. Determining the most appropriate environment for the probiotic to have the most beneficial effect is important.

These are some ways that probiotics may potentially help reduce antibiotic resistance in several different ways. However, more research is needed to fully support and better understand the relationship between probiotics and antibiotic resistant bacteria. The strains, dosages, timing, patient populations, and infection still need to be investigated to determine the most effective use.

Overall, I do not think there is enough information and research to support a claim that probiotics may potentially help to reduce antibiotic resistance. However, I do think that it is something to consider for further research. I’ve written an entire article on a more common question, how to take probiotics when you are prescribed antibiotics. And I’ve also looked at the research on the best time of day to take them to maximize colonization in your gut, which is when the bacteria (or yeasts, etc.) are able to stay in your system long enough to provide health benefits. 

Read some of my other articles

I’ve written quite a few pieces on probiotics and health, based on the questions I get at my pharmacy. Visit some of my other ones to learn more about the possible benefits of these increasingly popular supplements, and how to increase your gut health:

Apple cider vinegar and probiotics – Both apple cider vinegar and probiotics are also linked with bolstering immune health, albeit through differing mechanisms. Introducing beneficial bacteria to the gut, may be able to possibly interact positively with the immune system, while ACV may foster a healthier gut environment, indirectly supporting immunity. However, bear in mind the research on these benefits is much more robust for probiotics than ACV. Everyone’s physiological responses can differ, so what works for one may not work for all. Always consult a healthcare provider if you have any underlying health conditions.

How to take them with antacids – many patients with stomach issues take an antacid. Of course, this means that you are changing the acidity levels in your stomach and gut. So I write up how this impacts the survival and efficacy of the supplement.

Top foods for a health gut – hint, it’s probably what your grandmother wanted you to eat (minus the cookies!). A gut-friendly diet consists of plant-based foods that are high in fiber, beneficial for feeding the gut microbiome, and producing short-chain fatty acids (SCFAs) that contribute to overall health. There are two types of fiber: soluble, which increases stool bulk and may lower blood cholesterol, found in fruits, vegetables, and legumes; and insoluble, which aids in normal intestinal movement, sourced from whole grains and brown rice. Fermented foods like yogurt, kefir, sauerkraut, kimchi, and tempeh, rich in lactic acid, are also beneficial for the gut microbiota.

Prebiotics 101 – Prebiotics, which are crucial for promoting a healthy gut microbiome, work by nourishing the beneficial bacteria and the microbiome in your gut. Prebiotics serve as a food source for the microbiome in your large intestine and colon, getting digested and fermented by gut bacteria to produce substances beneficial for your colon, intestine cells, and overall health. A healthy microbiome can prevent the overgrowth of harmful bacteria, reducing problems such as gas and diarrhea. Learn about the best prebiotic foods.

Pharmacist Kari Raman

I’m Kari Raman PharmD, RPh, and I am a licensed, practicing pharmacist. I hold a Doctorate in Pharmacy from The University of the Pacific, and I’ve served patients in retail, compounding and hospital pharmacies.

Probiotics are confusing!

One of the most common questions I get asked by patients is about probiotics. And the truth is, probiotics are not as well understood by the healthcare community as they should be.

So I’ve been reading a lot of probiotic clinical trials, and sharing what I’m learning here.

I hope Pharmacist Probiotics helps you find out if there is a type of probiotic that works for you!