How to help your Gut stay in balance after antibiotics
The days when antibiotics were doled out like Smarties for every cough and sniffle are long gone. Overall, prescription rates for antibiotics have dropped dramatically in the last few years as doctors try and combat the rising problem of antimicrobial resistance.Last week, researchers warned that antibiotics may actually harm children who take them. Scientists at the University of Oxford and Public Health England found that preschoolers who take antibiotics for coughs and colds are more likely to get ill in the future.
The days when antibiotics were doled out like Smarties for every cough and sniffle are long gone. Overall, prescription rates for antibiotics have dropped dramatically in the last few years as doctors try and combat the rising problem of antimicrobial resistance.
Last week, researchers warned that antibiotics may actually harm children who take them. Scientists at the University of Oxford and Public Health England found that preschoolers who take antibiotics for coughs and colds are more likely to get ill in the future.
Their study, published in the latest issue of the British Journal of General Practice, looked at the data from 250,000 children aged one to five and found that those who had more than two courses of antibiotics from their GP were 30 per cent more likely to visit a doctor or spend time in hospital. Scientists believe the drugs may kill beneficial bacteria in the gut which help keep other bugs and germs in check.
Professor Helen Stokes-Lampard, chairman of the Royal College of GP’s says: “This research drives home how important is it for doctors and patients – and particularly the parents of young children – to understand that antibiotics do not work for every infection and should not be prescribed for the most common childhood conditions such as colds, coughs, ear infections and sore throats, which are usually caused by viruses.”
Sometimes, though, antibiotics are unavoidable – so how do you know when you really need them, and how can you protect your health if you’ve no choice but to take a course?
The golden rules
Antibiotics can be life saving drugs for severe infection-related conditions such as sepsis,” says Professor Stokes Lampard. “But instances where children who have an infection really do need antibiotics should be relatively uncommon.”
Dr Fiona Cornish, a GP based in Cambridge, says antibiotics should still be prescribed when really needed. “I will always do my best to prescribe antibiotics appropriately, for example, in the case of someone who is suffering from a severe urinary tract infection. We need to be careful not to withhold antibiotics when they are actually the best remedy available.”
There are some groups – people with cystic fibrosis, for example – who have to take antibiotics daily to keep themselves healthy, she adds. “Women with cystitis may also need antibiotics, particularly if the problem is severe or they are pregnant.” Older people with urinary tract infections do better when they are given doses of antibiotics early on, according to a study this year by Imperial College London and Public Health England.
Meanwhile, warning signs that a child may have an infection which is bacterial include a very high temperature, over 38.5 degrees centigrade, cold fingers and toes, confusion and delirium and persistent symptoms that don’t improve after 48 hours. Rapid deterioration in symptoms and vomiting are also red flags.
When you are given antibiotics, the golden rule is always take the course as directed. Nowadays GPs do not prescribe antibiotics lightly, so patients should take them as directed and finish the entire course, even if they start to feel better.
Dosages can also be fixed to reduce the likelihood of antibiotic resistance developing. Dr Cornish suggests checking with your doctor that the antibiotic you are being given is the right one – antibiotics that treat a narrow spectrum of bacteria are generally better than broad spectrum antibiotics that wipe out species across the board.
Augmentin (co-amoxiclav) and ciprofloxacin are broad spectrum which aren’t needed in the case of simple chest infections, which can usually be treated with the less broad spectrum amoxicillin. Strep throat is usually treated effectively with pencillin, a narrow spectrum antibiotic.
Depending on a person’s symptoms, GPs will sometimes issue a ‘delayed prescription’ for a patient to collect if their condition (or that of their child) doesn’t improve, or starts to get worse over the coming days.
Research by University College London found that a single course of antibiotics can change the composition of the microbiome for at least a year. But when you do have to take them, there are ways to minimise the damage to your gut microbiome, which is made up of a complex community of trillions of bacteria.
Glenn Gibson, professor of food microbiology at the University of Reading, says it’s “essential” when taking antibiotics to take prebiotic foods – which provide nutrition for microbes – and probiotics, which are living microbes that can be taken as capsules, pills or in food form.
“They can certainly help resist the negative effects of antibiotics on the gut microbiome. They are routinely given in some countries when antibiotics are prescribed. That should happen here too. I tell anyone I know taking antibiotics to take prebiotic foods or probiotics too.”
Probiotics like Custom Probiotics CP-1 can help with many issues such as gastroenteritis, IBS, transit time, and abdominal discomfort (including gas). Current research is also looking at brain effects and influences on the symptoms of obesity. For young children probiotics like Probiota Infant are a good choice.
The good gut diet
Some studies do seem to show that eating prebiotic and probiotic foods can reduce the impact on the microbiome of taking antibiotics. The three K’s; Kefir, kombucha and kimchi. Kefir is a super yoghurt drink which contains five time the diversity of microbes as traditional yoghurt, kombucha is a Russian tea drink which contains yeast and fungi and kimchi is a spicy fermented cabbage pickle from Korea rich in ‘good’ lactobacilli and bifidobacteria.
Sauerkraut is the less spicy version, and another excellent prebiotic food containing indigestible fibre which the microbes thrive on.
As a fizzy drink, kombucha can seem like a treat to children – but if they’re turning their noses up at the three Ks, try mixing kefir in with their favourite yoghurt or ice-cream.
People who need to take antibiotics can also protect their gut flora by avoiding artificial sweeteners. Gut microbes can’t easily process these and produce weird metabolites which seem to have a damaging effect. It is also wise to stay away from highly processed food which contains lots of chemicals such as emulsifiers and preservatives which disturb the balance of bacteria in the gut.
Eating plenty of fibre can help nourish the good bacteria which thrive in the lower intestine. Plant foods high in polyphenols such as nuts, berries, olive oil and red wine may also enhance the growth of beneficial bacteria.
And mothers who are still breastfeeding a young child who is taking antibiotics are also helping to boost their child’s good gut bacteria. It’s how a mother passes good bacteria onto her baby and will help ameliorate any harmful effects of the drugs.