If you have to take an antibiotic, should you take a probiotic, too?

It probably won't hurt, and it could help, says Scott Gavura at Science Based Medicine. But it's also worth taking a closer look at the nuance behind probiotics, too. These are promising medications and a fascinating field of research, but educating yourself on what we do know and what we don't (especially when it comes to purity of various products) is a really good idea.

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  1. It should be noted that most trials were sponsored by manufacturers, introducing an additional potential bias in the individual studies that would be reflected in these results.

    Funny how this blog (science-based medicine) never includes this warning for pharma drugs.

  2. The regulatory question is muddied by the fact that certain probiotics are unquestionably actual food or drink, not merely dietary supplements, with possible secondary benefits to those taking antibiotics. If I'm already eating yogurt with breakfast every morning, and that yogurt includes half a dozen species of bacteria, some of which (e.g. L. acidophilus) could reasonably be expected to survive past the stomach, and I'm eating it first and foremost because I like it, then at the very least there's absolutely no reason for me to stop eating this stuff when I'm on antibiotics. Similarly, hefeweizen is arguably a source of Saccharomyces, so you can argue that you're drinking it for medicinal purposes; if I were on antibiotics and picking a beer off an extensive menu, I might use that as a rationale to choose a hefeweizen over, say, an IPA, but I'd be having a beer in any case. People still jokingly use "medicinal purposes" as an excuse to drink gin and tonic, even in areas where malaria has been effectively exterminated.

  3. I'm not disagreeing with you; I'm backing up your assertion with a citation. I'm also providing the names of specific antibiotics with this side effect, for the benefit of anyone else reading this who might not read up on their meds before drinking.

  4. Immediately though of Stimu-crank brand pep pills.
    Clerk: "You can't take that many pep pills at once!"
    Homer: "Don't worry. I'll balance it out with a bottle of sleeping pills."

    Incidentally if drinking booze when on anti-biotics is wrong, I don't wanna be right. I adhere to the Nanny Ogg school of medicine which is if you're ill you should drink your favourite drink, because if you're gonna be ill you might as well enjoy yourself. I think Granny Weatherwax's method was to give someone any old cure and insist that they felt better.

  5. That's a great example of why Science Based Medicine is just industry propaganda. They completely ignored the dozens of studies that empirically show that corporate sponsorship of research is an enormous problem, and instead came to the conclusion that it isn't a big problem based on the 'facts' that:

    • "Frivolous accusations of conflict has a 'chilling' effect on the conduct of industry research."

    • "Those who claim, falsely, that there is an association between vaccines and autism have used the slightest appearance of conflict to dismiss the evidence against any role of vaccines in autism."

    • "There also seems to be an unfair asymmetry. While mainstream medicine is wrangling with this thorny issue, those on the fringe may ignore their own conflicts."

    So even though it's a proven fact that by far the biggest predictor of whether or not a trial will be 'successful' is whether or not it's corporately funded and/or conducted by researchers with industry ties[1], none of this matters (and is not even worth mentioning) because of something something alternative medicine.

    Of all the blogs I've read, SBM has got to be by far the most intellectually dishonest. Literally every single post is dripping with all sorts of logical fallacies and other dishonesty in order to promote whatever the current pharma-drug-of-the-day is. And whenever it comes time to actually demonstrate the safety or efficacy of whatever they're promoting, they always change the subject by bashing some random thing from alternative medicine that has nothing to do with the topic at hand.

    [1] Too many studies to list, but a couple examples:






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