Leukocytes
07.05.2019

What are the best probiotics after antibiotics for children? What is a good probiotic to take after antibiotics, for diarrhea or constipation? All possible options

After taking antibiotics, most patients feel mild or significant discomfort in the intestinal area, suffer from diarrhea or, on the contrary, constipation. Doctors' recommendations in such cases include taking foods and medications with live strains of so-called beneficial bacteria.

What are probiotics for?

  • Probiotics such as Lactobacillus spp., Bifidobacterium spp. and Saccharomyces boulardii, are strains of living microorganisms that are components of the normal intestinal microflora and are largely responsible for our health. They are obtained from food or in the form of medications.
  • Probiotics improve antibacterial therapy because they combat microbial adhesion and growth pathogenic flora, have immunomodulatory properties and improve the integrity of the intestinal barrier. In patients treated with antibiotics, probiotics help restore the microbial flora and increase treatment tolerance.
  • Probiotics should be used cautiously, in consultation with a doctor, especially in premature infants and patients with severe immunodeficiency

When is a probiotic prescribed?

Taking antibiotics is necessary for treatment (if prescribed by a doctor). But antimicrobial drugs kill all bacteria. Thus, along with pathogens, medications kill the good bacteria in the gut, leaving the body defenseless against pathogens such as fast-growing Candida albicans. After a course of antibiotics, this yeast can quickly become dominant in the small intestine.

Taking probiotics before, during and after the cycle antimicrobials may help maintain the balance of microorganisms in the digestive system. Many Candida sufferers doubt this, thinking that antibiotics will quickly kill off the good bacteria in probiotics. However, research has shown that probiotics are extremely effective during antibiotics.

Features of therapy when taking antibiotics

To maximize beneficial effect probiotics, space their intake with antibiotics at least for two hours. In this case, less “good bacteria” will be killed by antibiotics in the intestines.

There is a lot of confusion about whether probiotics should be taken before, during, or after meals. Luckily, a 2011 study looked at exactly this question. The researchers created a synthetic digestive system in the laboratory and tested it in different scenarios using a commercial probiotic. They found that probiotics survived best when taken with meals, or 30 minutes before meals. When you take these medications or foods, just be sure to drink or eat them with or just before your next meal.

Side effect of antibiotics

Well strong antibiotics can kill virtually all bacteria in your digestive system, eliminating competition and clearing the way for fast-growing pathogenic flora to immediately try to fill the gap. Taking probiotics during antibiotic treatment can help slow the growth of pathogens by replenishing the gut with beneficial, healthy bacteria. Beneficial bacteria maintain balance and reduce the side effects of antibiotics. A 2008 study published in the Journal of Clinical Gastroenterology found that probiotics significantly reduced diarrhea in patients taking antibiotics.

If you really need to take antibiotics, a course of good probiotics will help and will provide two types of benefits: relief from side effects antibiotics, and protecting the balance of microflora in the long term.

Use of dietary supplements for therapy

  • Probiotic preparations in liquid, capsules, powder or tablets are not a medicine. These are biologically active food additives that can establish balance and bring the body into normal condition. Therefore, such drugs do not require a prescription.
  • In any case, if the doctor, when prescribing antibiotics, did not suggest that you drink live bacteria, you should ask him the appropriate question. But which probiotics are best?
  • It is believed that liquid probiotics are better because they take live bacteria, not frozen or put into a dormant state, allowing you to start working on restoring your gut flora immediately. This is especially important when it comes to the health of a child. The drug must contain strains of lacto- and bifidobacteria, which are what the gastrointestinal tract requires after treatment with antibiotics.

After past diseases When treatment was carried out with antibiotics, the child needs to restore the intestinal microflora. This is where probiotics and prebiotics come to the rescue. Preparations with beneficial microflora are prescribed not only for diseases gastrointestinal tract: they are indicated for the purpose of strengthening the immune system, for the prevention of viral diseases, as well as in a number of other cases. How effective are they, which ones are considered the best? Let's consider the mechanism of their work, the main indications, and also learn about the most effective drugs.

Beneficial intestinal microflora is necessary to prevent viral diseases and dysbacteriosis

How it works?

When a person is healthy, millions of bacteria live in his body - useful and not so, most of which help break down nutrients. Sometimes the balance of microflora is disturbed for some reason, and then there are fewer beneficial microorganisms. This can happen as a result of undergoing a course of therapy with drugs that kill the bacteria that cause the disease, and at the same time cleanse the intestines of all other types of microorganisms. As a result, the functioning of the gastrointestinal tract is disrupted, which in turn leads to a decrease in immunity.

What are the differences between probiotics and prebiotics?

Prebiotics and probiotics have similar names, but have fundamental differences. Moreover, the former harmoniously complement the latter and enhance their therapeutic effect. Both have a beneficial effect on the body, causing the intestines to work more efficiently. Thanks to this, such substances are used in combination, helping to get rid of flatulence, constipation, cramps, and abdominal pain.

Probiotics are live microorganisms that inhabit the intestines healthy person. Prebiotics are chemical organic substances, which help these microorganisms grow and reproduce more efficiently. On Dr. Komarovsky’s website, such substances are defined as food for beneficial microorganisms.

Probiotics

Probiotics normalize the intestinal microflora, populating it with beneficial microorganisms - most parents know this. However, these drugs have a lot of other beneficial properties, thanks to which they are prescribed quite often. We list the indications for the use of probiotics:

Along with beneficial microflora, doctors often prescribe prebiotics. These substances work a little differently. They enable beneficial microorganisms to multiply more efficiently, that is, they are prepared for probiotics favorable conditions. In this regard, prebiotics are prescribed in advance, and sometimes together with probiotics.

Prebiotics themselves do not have a therapeutic function; their task is to help the beneficial bacteria work. Pharmacists use this quality to produce drugs that contain both pre- and probiotics. Prebiotics can also be found in foods - they are found in fiber, corn, beans, garlic, onions and cereals. What benefits do they bring? Let us list the positive effects that these substances have on the body:

  • help eliminate excess mucus from the intestinal walls;
  • help to reproduce normal microflora in the body, helping to increase its amount tenfold;
  • suppress the proliferation of pathogens - salmonella, shigella, vibrio cholerae;
  • accelerate the healing process of intestinal tissue;
  • stimulate peristalsis, increasing the output of feces, which relieves the patient from constipation;
  • stimulate local immunity how they affect pathogenic microflora;
  • help normalize acidity, thereby creating conditions for the proliferation of beneficial microflora.

The use of prebiotics allows you to normalize peristalsis and relieve your baby from constipation

Next we will mainly talk about probiotics, since prebiotics are only auxiliary. First, let's talk about how to make sense of the sea of ​​drugs that have flooded the pharmaceutical market.

Classification and release form

Today, pharmacies offer a whole list of medications to improve intestinal microflora. One way of classification is percentage one or another type of bacterial strain. For example, there are monoprobiotics, made from one type of bacteria, and polyprobiotics, which contain several types of microorganisms. Separately, there are preparations containing beneficial bacteria and enterosorbents, as well as yeast-like fungi and spore bacilli.

Another type of classification is based on what specific microorganisms are included in the drug. Probiotics are distinguished:

  • bifido;
  • lacto;
  • non-pathogenic coli species ( coli);
  • containing yeast-like fungi;
  • non-pathogenic enterococci;
  • lactic acid streptococcus;
  • Saccharomyces boulardii (Saccharomycetes boulardii) are yeast fungi.

Almost all of the listed microorganisms in one combination or another are included in probiotic preparations. They may also be contained in products. For example, products that can improve intestinal function have been known since ancient times - kefir, cottage cheese, yogurt, etc. However, we will talk about pharmaceutical products - dietary supplements and other medications.


Regular natural yogurt or kefir can be a source of beneficial probiotics

Let's talk separately about the generations of probiotics - there are only five of them. Despite the fact that from generation to generation these drugs changed and became more and more complex, today they are all used and are available in abundance on the market. pharmaceutical market. Let's look at them in more detail:

  • 1st generation are monoprobiotics containing a single type of bacteria.
  • 2nd generation – the so-called antagonists. They do not live in the human intestine, but when ingested they inhibit the growth of pathogens and are then completely eliminated.
  • 3rd generation – polyprobiotics containing two or more types of microorganisms.
  • 4th generation – combination drugs. They contain, in addition to one type of beneficial bacteria, substances that promote their reproduction.
  • 5th generation – polyprobiotics, combined with substances that promote the proliferation of beneficial microflora.

Probiotics are produced in the form of powder, solution, drops. It is believed that children under three years of age are best given liquid preparations, however, the powder can also be easily diluted in water or other liquid. The main thing is to follow the dosage so as not to cause an aggravated reaction to treatment.

Top 7 Best Probiotics for Children

Probiotics are prescribed by a doctor, so you should buy them only on his recommendation. At the same time, there are means of the same type of influence that are interchangeable. In this regard, in some cases it is possible to replace the medication prescribed by the doctor with another that works the same way. We have collected in this material the best probiotics for children under one year old, which can also be given to older babies. In addition, the composition, dosage and indications were indicated.

This drug is produced in Germany and is one of the most popular for the treatment of dysbiosis in children and adults. Hilak Forte is also used in the complex treatment of eczema, urticaria, and neurodermatitis. It is indicated for poisoning, salmonellosis, and candidiasis.


The drug Hilak Forte is the most popular medicine for the treatment of dysbiosis (we recommend reading:)

The drug contains germ-free aqueous substrates of metabolic products of coli and lactobacilli. Hilak Forte promotes soft recovery microflora, successfully preserves the functions of the mucosa. In addition, lactic acid, which is also in its composition, helps restore normal stomach acidity.

Available in the form of drops that need to be taken three times a day. Infants - 15-30 drops at a time, older children under 6 years old - 20-40 drops.

If probiotics are required for newborns, Rotabiotic Baby is ideal. The drug is produced in Bulgaria and contains live lyophilized lacto and bifidobacteria. In addition, the medicine contains extracts of fennel and chamomile. The manufacturer claims that this composition is most suitable for children. Lactobacilli help bifidobacteria to reproduce, creating for this ideal conditions. Fennel and chamomile extracts improve digestion, help reduce gas formation, and have an antiseptic effect.

Bifiform Baby

This probiotic will help children with dysbiosis, even if they suffer from lactose intolerance. It contains only bifidobacteria and lactic acid streptococcus. Bifiform's release form is somewhat unusual - it is a bottle with an oil solution, and the lid contains powder with bacteria. Before use, these two components must be combined to obtain ready-made drug. Thus, the manufacturer extended the shelf life of the dietary supplement. Bifiform belongs to the 5th generation.

Linex for children

The drug is available in the form of capsules, which not only contain two types of bacteria - bifido and lacto, but also substances that promote their reproduction. Good composition complement the shell components, which help ensure delivery of the drug to the address. Linex can be used together with antibiotics to neutralize their harmful effects on microflora, which is why it belongs to the 3rd generation. Indicated for children with infancy, in whom there is a delay in the formation of normal microflora.

Colibacterin

Powder for oral administration is a specially prepared E. coli. The drug has the property of counteracting pathogenic microflora, which allows you to normalize intestinal function. In addition, colibacterin normalizes immunological processes, improves digestion and promotes the synthesis of vitamins. It is not prescribed to children under six months of age, as there is a high risk of allergies. First generation drug.

Enterol

This French-made drug is a prominent representative of the 4th generation. It contains lyophilized live microorganisms called Saccharomyces boulardii, as well as lactose monohydrate as an excipient. Yeasts, having fulfilled their function, are excreted from the body. Enterol is allowed to be given to newborns, but not more than 1 sachet per day.



The drug Enterol is indicated even for newborns, but in limited doses

Our rating included a drug from a Russian manufacturer – Normoflorin, which belongs to the biocomplexes. This dietary supplement is effective for gastritis, duodenitis, pancreatitis, cholecystitis, and dysbacteriosis. Babies under one year old are given half a teaspoon three times a day, those older - 1 tsp. Quite effective and inexpensive Normoflorin is recommended for adults.

Mixtures with probiotics for infants

We have described medications, most of which can be given to children from birth. However, if the baby is on artificial feeding, it is convenient to give him a mixture with probiotics and vitamins. Firstly, it takes into account the dosage required for the baby’s body. Secondly, the mother gets rid of the need to give the baby medicine several times a day. So, let's look at the most popular probiotics for infants, presented in the form of a mixture:

  • mixture Malyutka with content dietary fiber and nucleatides (we recommend reading:);
  • fermented milk NAS from Nestlé (we recommend reading:);
  • Nutrilak premium product (we recommend reading:);
  • Similac mixture with probiotics;
  • Humana mixture with prebiotics.

There are other formulas on the market for newborns and children over one year old that contain probiotics. Your pediatrician will help you choose the best one.


Using a mixture with prebiotics can effectively solve the problem of dysbiosis

Which probiotic should you choose?

Since the list of indications for probiotics is quite large, it is difficult to choose the right one for the treatment of a particular condition. We have compiled a table of probable diseases that can be treated with dietary supplements. Also in the table you can see which drug is suitable for treating a particular condition. The main thing is to strictly adhere to the dosage, and if improvements do not occur within a week, it is better to consult a doctor.

Patient's conditionType of bacteriaPossible drugs
DysbacteriosisIt is recommended to use drugs with lactobacilli in stages, then with bifidobacteria, and only then with colibacteria. It is also possible to use complex drugsLactobacterin, Bifidumbacterin, Colibacterin (we recommend reading:)
Viral bowel disease (or suspicion of it)LactobacilliLactobacterin, Narine (we recommend reading:)
If diagnosed fungal infection intestinesBifidobacteriaBifidumbacterin, Bifiform
Bacterial infectionLacto and bifidobacteria at the same timeLinux (we recommend reading:)

The drug Bifidumbacterin is indicated for fungal disease intestines or dysbiosis (we recommend reading:)

Method of use

Almost all types of probiotics should be taken with or after meals 3 times a day. The doctor may prescribe a course - a certain number of days, but probiotics can be taken until a stable improvement in the condition occurs. We have compiled into one list expert advice that will help you properly organize your medication intake:

  • If the medicine is in capsules, only the contents can be given to the baby. Usually the capsules are easy to open, and the powder can be poured into a spoon and diluted with water.
  • Majority similar drugs It is not recommended to dilute with milk.
  • If a child is taking antibiotics, at the same time they should be given dietary supplements with beneficial microflora, and not wait until the baby begins to have diarrhea.
  • For the treatment of chronic diseases, drugs of this kind should be taken 30 minutes before meals.
  • If one year old baby diarrhea, probiotics should be given 4-6 times a day, and taken until the stool returns to normal. Usually the condition improves steadily within the 2nd day.
  • These medications can be taken with mineral water. If a child has gastritis with increased acidity, you can drink the capsule with alkaline mineral water.
  • Do not dilute the powder or solution with live bacteria in water with a temperature above 37˚C, otherwise its effectiveness will decrease.

The capsules are suitable for older children, but for infants you can simply break them and give the contents

Komarovsky's opinion

Not all pediatricians believe that treatment with probiotics is necessary element recovery after taking potent drugs. Dr. Komarovsky’s website states that “alien” microorganisms, even having passed the barrier from gastric juice and once in the intestines, they do not take root there, but are excreted by the body. It has been proven that there are benefits from probiotics, but they are much more modest than advertised. So, when drugs with microflora can be useful:

  • Only some drugs can be a salvation from acute diarrhea that occurs in a child due to rotavirus infection.
  • Beneficial microflora from dietary supplements helps reduce diarrhea in children caused by taking antibiotics.
  • Infant formulas with probiotics and vitamins also reduce diarrhea.
  • Yoghurt bacteria are indicated for people whose body does not break down milk sugar. This condition is usually observed in older people.
  • Reproduction of microflora that enters the body along with dietary supplements lasts about 3 weeks. It is during this period that phagocyte activity is recorded in the blood. Theoretically, this phenomenon suggests that local immunity, as well as general immunity, becomes stronger, but in practice this has not been proven. Advertising of probiotics is a little disingenuous, since there is no certainty that their use leads to good health. In addition, any competent specialist will agree that one’s own microflora affects the immune system an order of magnitude higher than the one introduced.

There is also a theory that taking probiotics can prevent intestinal cancer. This statement has not yet been proven. In this regard, Dr. Komarovsky does not recommend placing special hopes on such drugs.

Alternative to dietary supplements

Buying drugs with live microflora does not always make sense. As a rule, they do not belong to budget medicines, with the exception of only a few. If the child does not have serious problems with a stomach that requires specialist intervention, you can offer him yoghurts. “Yoghurt therapy” is the prevention of dysbacteriosis, it will help improve daily stool, will improve appetite, especially if carried out according to the rules:

  • If you buy yoghurts in a store, the effect will be minimal. As a rule, it does not contain the number of bacteria stated on the packaging. Manufacturers of dietary supplements also sin in the same way. It is advisable to prepare live yogurt yourself using starter and milk. In this case, it is not at all necessary to have a special device - a yogurt maker. This useful product You can cook it in a thermos, in a glass jar, having previously wrapped it, in a slow cooker. You can come up with a lot of options and choose the best one.
  • You should choose a starter that contains lacto- and bifidobacteria.
  • You can make liquid yogurt, or you can make thick yogurt. It all depends on the starter and the fat content of the milk.
  • You should give yogurt to your child every day, preferably 2 times a day.
  • You can offer yogurt to babies aged 1 year and older, and some pediatricians suggest starting at 8 months.
  • You can add pieces of fruit, honey (if there are no allergies), nuts, cereals, breakfast cereals. However, such variety is possible for feeding a baby from three years old.

If you take a two-week course of treatment, bowel function will become more efficient, which will lead to improvement general condition child. The stool will be regular, and problems such as flatulence, irritable bowel syndrome, belching may disappear without a trace.

Probiotics – good and quite safe method getting rid of intestinal problems, treating dysbiosis. However, not all experts unanimously consider them necessary. We have already written that the microorganisms our body needs are also fermented milk products, the use of which can eliminate many unpleasant symptoms. Maybe they will help you and your child balanced diet And active image life, not long list Dietary supplements. Choose your own path to health by making informed decisions.

(1 rated at 5,00 from 5 )

In general, it seems to me that in modern world Probiotics should be taken not when you have health problems, but constantly. Unfortunately, many of the products that we now buy in stores have a small amount of useful ingredients in their composition, which is why it is so important to replenish the body good bacteria, especially for children. When I first started introducing fermented milk into my child’s diet, I began to cook it myself - with Bifidum sourdough. And I have never regretted it. For me, this option is good because I always know what kind of milk I’m preparing from, that the yogurt will be fresh (it is stored for a maximum of 3 days in the refrigerator), under what conditions it is made (everything that comes into contact with the product during preparation and fermentation must be doused with boiling water ).

Hello, please tell me we have a problem with the stool of the youngest, 1.5 years old, I’ve been singing it with Duphalac for 2 months, but it’s hard to go to the toilet after 2-3 days. Now the eldest has started having problems, and she can walk after 3 days. What to do?

  1. Hello, Elena. There are many reasons for the development of constipation: from nutritional disorders to somatic and neuropsychiatric disorders. If both of your daughters experience constipation, the problem is likely nutritional in nature (disturbed diet) or functional (impaired intestinal motility). First of all, it is necessary to increase consumption clean water and products with high content fiber (vegetables, fruits, porridges except rice and semolina, wholemeal bread, etc.), as well as fresh fermented milk products. To establish a regular bowel movement regimen, you should continue to use Duphalac or similar in action safe means(Forlax, Fitomucil, etc.).

    • Hello, Elena! No, thymomegaly has nothing to do with oncological diseases, this is an enlargement of the thymus gland. Children with thymomegaly are at risk for developing allergic, endocrine and oncological diseases. Often, with age, the size of the thymus returns to normal. To control the situation, an in-person consultation with a pediatric allergist-immunologist is necessary.

    • Good evening! The baby is 27 days old, in the hospital he was treated with summed, now we are worried about eosinophilia, it was 10, now it is 15. Perhaps this is due to intestinal dysbiosis after taking an antibiotic. Please advise which drug is best to give to infants to restore intestinal flora

    1. When prescribing antibiotics, it is important to take parallel medications for the intestines, for example Linex, Hilak Forte, Bifidumbacterin, Acipol, to avoid the formation of dysbiosis. The specific drug will be prescribed by the pediatrician during a face-to-face consultation.

    • If the problem is intestinal dysbiosis, you need to contact your pediatrician for tests and coprograms. Based on the results, treatment will be suggested.

    • Hello. As it turns out, my child has rotavirus. I've been sick for five days now. There was no diarrhea or vomiting, the temperature was within 38 degrees for the first two days. Out of ignorance, I fed the child as usual: milk porridge, meat soups And. d. How dangerous is a diet disorder and should probiotics be given now? Thank you.

    1. If the child’s appetite is not impaired, there are no symptoms such as diarrhea or vomiting, then the diet does not need to be changed. Taking probiotics is recommended after a rotavirus infection, which destroys the normal intestinal flora.

    • Colic is a problem that plagues almost all babies under three months, and there are no drugs for colic with a proven effect. You can only minimize the manifestations by frequently placing it on the tummy (if gases are bothering you), wearing it in a column after feeding, and applying heat to the abdominal area. The use of carminatives and simethicone-based medications is prescribed by a pediatrician during a face-to-face consultation.

    • Hello! The child is 2 months old, on IV, his stomach growls strongly, he pushes constantly, he cries when gas comes out and he has a bowel movement, he has loose stools and his facial skin is peeling! I started giving Bifidumbacterin, but they haven’t taken any tests yet! Sometimes she spits up a lot, an hour and a half after feeding!! Tell me, please, is there anything else I can serve?

    1. For children under 3 months of age, manifestations in the form of colic are typical, since the digestive system is in its infancy. The symptoms you described are exactly the typical picture of colic. For better discharge Gazikov hold the baby on his tummy before feeding, and then carry him vertically so that the swallowed air comes out. Of course, you need to wait for the analysis to rule out lactase deficiency, and dysbiosis in one form or another is present in almost all children of this age and does not need treatment, since this is a normal stage of colonization of the intestines with flora.

    It’s strange that the probiotic Active Flora Baby is not on this list. We took it to treat dysbiosis in our daughter. The effect came quite quickly. The diarrhea stopped, the stomach pain stopped. We drank it for 10 days, as prescribed by the doctor.


    Probiotics are medications, which contain strains of living bacteria. The product is sold in various forms release and with different compositions. There are not only single-component probiotics, where only one type of microorganism is present, but also multicomponent ones. Unique properties The drug helps achieve the following results:

    • strengthening the immune system;
    • restoration of microflora and intestinal mucosa after taking antibiotics;
    • lowering blood cholesterol;
    • rapid removal of toxins and allergens from the body;
    • normalization of Ph balance in the colon;
    • improving the absorption of vitamins and microelements.

    Below are the best probiotics according to doctors and patient reviews. Please note that the information provided is for informational purposes only and is not a guide to purchase. For any advice you should contact specialists!

    There are contraindications. Consult your doctor.

    The best monocomponent probiotics

    Mono-ingredient probiotics contain only one strain of bacteria. These could be: bifidobacteria, lactobacilli, E. coli or bacilli. Such drugs are classified as first generation probiotics. That is, this was exactly the composition of the very first products for improving intestinal microflora. Despite the fact that probiotics are modified every year and have more complex formulas, monocomponent preparations do not reduce their popularity.

    2 Lactobacterin

    Best for newborns
    Country Russia
    Average price: 140 rub.
    Rating (2019): 4.6

    The first generation probiotic “Lactobacterin” is created on the basis of one component – ​​live lactobacilli. After entering the intestines, they produce lactic acid, creating favorable conditions for the formation of beneficial bacteria. The active component fights staphylococcus, Proteus and E. coli. Lactobacterin is allowed for babies from the first day of life. The probiotic has virtually no contraindications and side effects, therefore, is not capable of harming the fragile intestines of newborns.

    The drug is available in the form of a powder, hermetically packaged in bottles. Each pack contains 10 such bottles. The product can be used for no more than 10 days. The product is resistant to antibiotics, so it can be used simultaneously with antibacterial drugs.

    Indications for use:

    • diarrhea;
    • impaired intestinal function in newborns.

    Contraindications:

    • vulvovaginitis.

    1 Bifidumbacterin

    For the whole family
    Country Russia
    Average price: 232 rub.
    Rating (2019): 4.8

    A prominent representative of the first generation of probiotics is Bifidumbacterin. The one-component drug is available in the form of tablets, drops, powder and suppositories. The product improves metabolic processes, increases immunity and normalizes intestinal function in both adults and children from 6 months. It is worth noting that six-month-old babies can only take “Bifidumbacterin” in powder; other forms of release are approved for use from 3 years of age. If infants refuse to take the drug, then it is possible to prepare a solution based on breast milk.

    The active ingredient of the drug is bifidobacteria, which are active against strains of Escherichia coli, yeast-like fungi and staphylococcus. The course of treatment should not exceed 14 days. Only the attending physician can extend the period of admission.

    Indications for use:

    Contraindications:

    • individual intolerance;
    • allergy to probiotic.

    The best multi-component probiotics

    Multicomponent probiotics are called symbiotics, since they contain from 2 to 30 strains or several types of living bacteria. That is, the symbiotic formula includes more than two probiotics. For example, one preparation may contain four types of lactobacilli or a mixture of bifidobacteria and lactic acid streptococci. Thanks to more complex composition than in first-generation probiotics, symbiotics have a complex effect on the intestinal microflora. Below are the three best multi-ingredient probiotics based on customer reviews and medical recommendations.

    3 Bifiform

    Best for kids
    Country: Denmark
    Average price: 472 rub.
    Rating (2019): 4.5

    The composition of the symbiotic "Bifiform" includes enterococci and strains of bifidobacteria. Active substances normalize work digestive system Therefore, the probiotic is used for the treatment and prevention of dysbiosis in children and adults. The product also effectively combats constipation and diarrhea. The medicine strengthens immune system and serves as a preventive measure infectious diseases.

    For adults, the drug is sold in the form of tablets or capsules. For children The release form is more varied. "Bifiform Malysh" is presented in the form of a powder for preparing a solution with an orange-raspberry flavor. With the same taste there is chewable tablets"Bifiform Kids". And for very young patients it is produced oil solution"Bifiform Baby"

    Indications for use:

    • prevention and treatment of dysbacteriosis;
    • constipation and diarrhea.

    Contraindications:

    2 Acipol

    Maximum benefits – minimum contraindications
    Country Russia
    Average price: 337 rub.
    Rating (2019): 4.7

    "Acipol" is produced in capsules containing kefir grain and acidophilus lactobacilli. Since the shell is gelatinous, before taking the symbiotic for small children, it is recommended to open the capsule and mix the contents in one teaspoon of water or milk. The probiotic is approved for use by babies older than three months.

    The action of the active substances of the drug is similar to antibiotics. The product creates unfavorable conditions for pathogenic microbes, so it easily normalizes the balance of intestinal microflora. The probiotic is used for the prevention and treatment of dysbiosis resulting from poor nutrition or taking antibiotics. It is often included in the course complex treatment Gastrointestinal tract, for example, with colitis and enterocolitis.

    Indications for use:

    • intestinal infections and dysbacteriosis;
    • reducing intoxication during food poisoning;
    • chronic enterocolitis and colitis.

    Contraindications:

    • sensitivity to components.

    1 Enterol

    Best after taking antibiotics
    Country: France
    Average price: 450 rub.
    Rating (2019): 4.9

    The multicomponent probiotic "Enterol" was developed by French scientists. The symbiotic contains Saccharomyces boulardii - these are lyophilized live bacteria, and lactose monohydrate acts as an excipient. Having fulfilled their main function, yeast fungi in a natural way are excreted from the body. The drug is available in capsules or sachets of powder.

    Most often, Enterol is prescribed after a course of antibiotics. The probiotic fights the causes of diarrhea that could occur due to food poisoning or against the background of dysbacteriosis. The product should not be taken by children under 1 year of age without a doctor's prescription.

    Indications for use:

    • diarrhea;
    • rotavirus infection;
    • irritable bowel syndrome.

    Contraindications:

    The best sorption probiotics

    This category presents the best probiotic complexes, which in addition to living microorganisms include a sorbent. In the preparation, bacteria are united into small colonies (20-180 living cells), which are fixed on sorbents, most often Activated carbon. This increases the survival rate of microorganisms in the stomach. A product with this composition gently and effectively cleanses the intestines, restores colonies of beneficial bacteria, and prevents poisoning and other stomach problems.

    3 Linux

    Produces B vitamins
    Country: Slovenia
    Average price: 263 rub.
    Rating (2019): 4.4

    The active ingredient of the drug "Linex" is libenin, which contains strains of live lactobacilli, bifidobacteria and enterococci. Once in the intestines, beneficial microorganisms not only begin to actively multiply, but also synthesize vitamins B1, B2, B6, B12 and K. Lactic acid bacteria increase the acidity of the intestinal microflora, which leads to inhibition of the growth and development of pathogenic microorganisms. Active substances do not give pathogenic bacteria attach to the intestinal wall.

    The release form of the drug is capsules. "Linex" is safe for health when correct observance dosage. The remedy is even prescribed infants, but first it is recommended to carefully remove the contents of the capsule and mix with breast milk or a mixture.

    Indications for use:

    • treatment and prevention of dysbacteriosis;
    • gas or heartburn;
    • diarrhea or constipation.

    Contraindication:

    • hypersensitivity to components.

    2 Probifor

    Best for poisoning
    Country Russia
    Average price: 730 rub.
    Rating (2019): 4.6

    The release form of Probifor is capsules or powder in sealed bags. The drug does not have age restrictions, so even newborns can take it from the first day of life. The probiotic consists of live bifidobacteria sorbed on activated carbon, lactose acts as an auxiliary substance.

    The product perfectly fights diarrhea, since bifidobacteria not only destroy pathogenic microorganisms, but produce antibacterial substances. Thanks to his unique composition probiotic in short time restores the structure of the intestinal mucosa, and fights poisoning and toxicity without the help of antibiotics. The drug can be prescribed in postoperative period or in preparation for surgery, childbirth, or caesarean section. Often used in complex courses of treatment of ARVI or influenza.

    Indications for use:

    • eczema and allergic reactions;
    • irritable bowel syndrome;
    • chronic colitis and pancreatitis;
    • bacterial vaginosis and colpitis (external use).

    Contraindications:

    • intolerance to probiotic components.

    1 Bifidumbacterin Forte

    Quickly removes toxins from the body
    Country Russia
    Average price: 215 rub.
    Rating (2019): 4.9

    The probiotic complex is available in capsule or powder form. Live bifidobacteria sorbed on activated carbon evenly populate the intestinal microflora. Active components normalize microflora, and charcoal eliminates intoxication. The drug very quickly rids the digestive organs of waste products harmful bacteria, outputs toxic substances and restores colonies of beneficial microorganisms.

    A probiotic is prescribed not only for indigestion, but also before a planned operation or after surgical intervention. The drug easily eliminates poisoning, constipation and diarrhea. Newborns are prescribed the drug from the first day of life only in powder; capsules are allowed from the age of three.

    Indications for use:

    • poisoning and allergies;
    • constipation or diarrhea;
    • intestinal infections.

    Contraindications:

    • lactase deficiency;
    • Individual intolerance to the components of the drug.

    The best synbiotics

    Synbiotics are preparations that contain probiotics and prebiotics. Probiotics are live bacteria that are part of the normal intestinal microflora. Prebiotics – organic chemical substances, creating ideal conditions for normalizing intestinal microflora. Complex drugs copes well with indigestion, since one capsule contains not only beneficial microorganisms, but also nutrient medium for them.

    3 Normoflorin

    Most natural composition, suitable for newborns
    Country Russia
    Average price: 400 rub.
    Rating (2019): 4.7

    "Normoflorin" is an effective biocomplex against intestinal dysbiosis. It improves peristalsis, restores microflora, and reduces cholesterol. It is based on three components: metabolites, lactitol and bacteria (bifido and lacto). Together they have an active positive impact on the gastrointestinal tract. The drug is suitable even for people with lactose and protein intolerance cow's milk. Important feature considered to be a completely natural composition.

    The manufacturer produces three types of “Normoflorin”, which differ slightly in composition. But most often they are advised to be taken in combination. The probiotic has been on the market for over 20 years. Is a complex useful substances, capable of helping even with chronic diseases Gastrointestinal tract (ulcers, gastritis, etc.). The kit includes a measuring cup. The product is used for the prevention and treatment of dysbiosis in children and adults. Does not contain dyes or preservatives.

    Indications for use:

    • stomach ulcer, chronic gastritis and etc.;
    • lactase deficiency;
    • dysbacteriosis;
    • disturbed microbiocenosis.

    Contraindications:

    • individual intolerance to components.

    2 Narine Forte

    Dietary fermented milk product
    Country Russia
    Average price: 350 rub.
    Rating (2019): 4.7

    The liquid probiotic contains a specially created strain of acidobacteria “Narine TNSi”, which takes root well on the mucous membranes of the gastrointestinal tract. The product fights all known pathogenic microorganisms. Together bifidobacteria and acidobacteria for a long time remain viable, which means the effect of normalizing the intestinal microflora is longer.

    The drink is recommended for use by adults and children with dysbiosis and intestinal infections. "Narine Forte" is prescribed after long-term use of antibiotics or hormonal drugs, as well as after radiation or chemotherapy. The product normalizes intestinal function after climate change. It can be taken by expectant mothers, women during lactation, as well as newborn or premature babies.

    Indications for use:

    • vitamin deficiency;
    • alcohol intoxication;
    • prevention of dysbacteriosis.

    Contraindications:

    • individual intolerance.

    1 Maxilak

    Best by popularity
    Country: Poland
    Average price: 440 rub.
    Rating (2019): 4.8

    Biologically active additive"Maxilak" is one of the most popular according to doctors and patient reviews. The drug contains live lactobacilli (4 species), bifidobacteria (3 species), lactococci and streptococci, and the prebiotic oligofructose is used to create comfortable conditions for them. This combination effectively suppresses the activity of harmful bacteria and stops their reproduction.

    The drug can be taken not only by adults, but also by children aged 3 to 14 years, subject to compliance with all prescriptions of the attending physician. The synbiotic is available in the form of capsules with an innovative patented Multi Resistant Encapsulation (MURE) coating. Capsules retain the viability of microorganisms even under aggressive influences external environment, so the product can be stored at high temperatures.

    Indications for use:

    • long-term treatment with antibiotics;
    • diarrhea or constipation;
    • dysbiosis.

    Contraindications:

    • hypersensitivity to synbiotic components.

    Thanks to the invention of antibiotics, mortality from infectious diseases has dropped to negligible numbers. Pneumonia and intestinal infections, which a hundred years ago claimed millions of lives, are now curable within a few days, even in outpatient setting. The name of Louis Pasteur is forever inscribed in the history of medicine.

    However, the same Pasteur who invented a means of fighting infection uttered the famous phrase: “Gentlemen! The microbes will have the last word.” And the scientist was absolutely right. Over time, it became absolutely clear that antibiotics also have plenty of their “skeletons in the closet.”

    Side effects antibacterial agents may be no less serious than the original disease that became the root cause of treatment. A study conducted by American clinicians proved that antibiotic toxicity has become one of the most common causes of death in hospitalized patients. But don't rush to conclusions.

    Let's try to consistently answer the burning questions: why sometimes the result of the use of drugs is therapy of consequences? And how to recover after antibiotic treatment?

    Antibiotics: side effects

    As you know, antibacterial drugs are divided into groups that have a common spectrum of action and similar side effects.

    Penicillins

    Antibiotics of the penicillin group are generally well tolerated. The most common side effects include rash and exfoliative dermatitis. However, the appearance of antibiotic-associated diarrhea during treatment with penicillins (drugs Amoxicillin, Augmentin, etc.) is not uncommon.

    Cephalosporins

    Relatively safe antibiotics cephalosporins of all four generations are considered. Among the side effects attributed to these drugs, diarrhea takes pride of place. Quite rarely, hypersensitivity reactions are recorded: rash and fever. Ceftazidime - antibiotic III generation- causes liver dysfunction.

    Macrolides

    Side effects of macrolides (for example, the antibiotic Sumamed) include nausea, vomiting, diarrhea, and rarely antibiotic-associated colitis and cholestatic jaundice.

    Fluoroquinolones

    When taking these drugs, more often registered gastrointestinal symptoms, including diarrhea, abdominal pain, nausea. Allergic reactions such as rash and itching develop much less frequently.

    Aminoglycosides

    Drugs in this group are among the most toxic. Of particular concern is the nephrotoxicity of aminoglycosides, which manifests itself in the development of acute renal failure, as well as ototoxicity leading to hearing impairment.

    So, the range of side effects of antibacterial drugs is extensive. But the most well-known adverse event associated with treatment with these drugs is certainly antibiotic-associated diarrhea. Let's try to figure out what causes this manifestation and how to deal with it.

    Antibiotics and diarrhea: causes

    Let's start with the fact that the probability of diarrhea or simply diarrhea during treatment with antibacterial agents is not so small: it ranges from 5 to 40%.

    Diarrhea during or after treatment with antibiotics can be caused by two completely different reasons:

    Stool disorder caused by changes in the composition of the intestinal flora is the symptom that in domestic medicine is usually called dysbiosis.

    Dysbacteriosis - truth or myth?

    Heated debates about dysbacteriosis have not subsided to this day. Many patients and doctors diligently look for signs of this condition and treat it. Meanwhile, Western medicine treats the concept of “dysbacteriosis” very reservedly.

    Note that in Russia nosological unit there is no such name, that is, there is no such diagnosis officially. This is largely due to the fact that the composition of the intestinal flora is too diverse to allow clear norm criteria to be established. Moreover, a healthy person has recovery mechanisms, and they start on their own.

    The condition, which in our country is regarded as dysbiosis due to the use of antibiotics, is called antibiotic-associated diarrhea by most European and American specialists. The main and often the only symptom of impaired intestinal microflora is loose stool.

    Pseudomembranous enterocolitis - an unfamiliar name for a familiar problem

    In approximately 5-15% of cases of antibiotic use, diarrhea that occurs during or after treatment is caused by the growth of Clostridium difficile. The disease that develops as a result of the proliferation of clostridia is called pseudomembranous enterocolitis. Most often, this complication is recorded in patients undergoing inpatient treatment.

    The diagnosis of pseudomembranous enterocolitis is considered primarily in any patient with diarrhea who has taken antibiotics in the previous three months and has been hospitalized.

    Symptoms of pseudomembranous enterocolitis include:

    • mild to moderately severe watery diarrhea;
    • cramping abdominal pain;
    • lack of appetite;
    • malaise.

    IN severe cases possible fever and dehydration. If signs of enterocolitis appear, it is necessary urgent consultation doctor And no self-medication!

    Dysbacteriosis after taking antibiotics: risk factors and solutions

    Much more often there is a less aggressive consequence of treatment with antibacterial drugs - dysbacteriosis.

    The likelihood of developing dysbiosis and, as a consequence, antibiotic-associated diarrhea increases if the primary infection is caused by clostridia, Klebsiella, Staphylococcus aureus and some other pathogens.

    In addition, people at risk for diarrhea associated with treatment with antibacterial drugs include:

    • aged people;
    • patients of inpatient departments;
    • cancer patients;
    • patients taking proton pump inhibitors.

    Let us remember that these drugs include drugs for the treatment of gastritis and peptic ulcer: Omeprazole, Lanzaprozole, Pantoprozole and others.

    So, what should those 5–39% of patients do who, during or after taking antibacterial agents, felt manifestations of dysbacteriosis?

    First of all, don’t be discouraged. In the vast majority of cases, diarrhea is not the reason for discontinuation of the main drugs.

    And secondly, at least one more drug will have to be added to the main list of medications.

    This is perhaps one of the most important discoveries in medicine of the twentieth century. Hard to imagine modern life without these medications. However, with all their advantages, antibacterial drugs also have serious drawback- they lead to development. To prevent this problem, doctors prescribe an appointment. How advisable is such a prescription, and how to properly take antibiotics with probiotics?

    When should you take probiotics?

    And these are the symptoms that many people experience after antibiotic therapy. This phenomenon in medicine is called antibiotic-associated diarrhea . The fact is that the antibacterial drug has a complex effect on the body. It cannot only affect the lungs, kidneys, etc. The effect of the drug extends to all organs, so the intestinal microflora may also be affected.

    It is known that the human intestine contains a large number of bacteria, an impressive portion of which are represented by bifidum and lactobacilli. These bacteria play very important role in the body - their presence is necessary for normal digestion, preventing the proliferation of pathogenic microorganisms and maintaining immunity. The use of an antibiotic can lead to the death of not only harmful microbes, but also beneficial intestinal bacteria. The result is the development of dysbiosis and antibiotic-associated diarrhea.

    According to various sources, antibiotic-associated diarrhea occurs in 5-30% of cases.

    It is known that certain antibacterial drugs are more likely than others to cause diarrhea. These are drugs such as:

    1. Protected penicillins (, etc.);
    2. Unprotected penicillins (Ampicillin);
    3. Cephalosporins (, Cefoperazone, etc.);
    4. Macrolides ( , );
    5. Lincosamides (Clindamycin);
    6. Fluoroquinolones (Ciprofloxacin);
    7. Tetracyclines (Tetracycline, Doxycycline).

    Antibiotic-associated diarrhea develops when there are three or more episodes loose stool, recurring for at least two days and arising during antibiotic therapy. Most people experience diarrhea within the first days of using an antibiotic. In other people, the disorder may appear within four weeks of stopping use. antibacterial drug. To prevent and eliminate diarrhea during antibiotic therapy, doctors prescribe probiotics.

    note

    In pharmacology, probiotics are drugs containing cultures of living bacteria that improve intestinal microflora.

    The need for probiotics

    Every now and then there are materials in the media questioning the effectiveness of probiotics. To understand the question of whether to take probiotics or not, it is worth turning to the results of world research. And a lot of research has now accumulated on the effectiveness of using probiotics in the fight against antibiotic-associated diarrhea.

    Scientists E.Videlock and F.Cremonini in 2012 conducted a meta-analysis of the results of 34 clinical trials, in which a total of 4138 people took part. Summarizing the results obtained, they came to the conclusion that the use of probiotics can significantly reduce the incidence of antibiotic-associated diarrhea.

    Does this mean that absolutely everyone needs to take probiotics? This is not entirely true. Firstly, antibiotic-associated diarrhea does not develop in all cases when treated with antibiotics. Secondly, light form Antibiotic-associated diarrhea soon goes away on its own without any consequences. Therefore, the decision on the need to use probiotics is made by the doctor, taking into account many factors ( pharmacological group antibiotics, duration of antibiotic therapy, history of episodes of dysbacteriosis, etc.).

    There are a large number of probiotics available today. The most popular among them are Linex, Bifiform, Enterol, Acipol, Probifol, more about which can be read in the article “”. How can probiotics be useful? The lacto- and bifidumbacteria included in probiotics are responsible for the following functions:

    1. Normalize the intestinal microflora, increasing the number of beneficial lacto- and bifidumbacteria;
    2. Prevents the growth of pathogenic bacteria in the intestines;
    3. Eliminates symptoms of dysbacteriosis - diarrhea and bloating;
    4. Take part in the synthesis and;
    5. Increases the intestinal absorption of calcium, iron,;
    6. Participate in the metabolism of bile acids;
    7. Participate in the enzymatic breakdown of macronutrients that are not absorbed in the intestine;
    8. Increases the body's immune reactivity.

    How to properly take probiotics with antibiotics?

    For probiotics to have a positive effect, they must be consumed correctly. Probiotics can be taken from the first days of antibiotic therapy, this will prevent intestinal dysbiosis. The most important thing is not to take medications in one dose, otherwise the antibiotic will simply kill lacto- and bifidumbacteria, and therapeutic effect will not be. There should be an interval of at least two hours between taking the antibiotic and the probiotic. This period of time will protect the beneficial bacteria of the probiotic from the action of the antibacterial drug.

    It is important to remember that food also affects the probiotic. As a rule, probiotics should be taken half an hour after meals with water.. At the same time, it is very important to monitor your diet. So, flour and butter products, all kinds of sweets, alcoholic drinks- inhibit the growth of lacto- and bifidumbacteria. Therefore, these products should be temporarily abandoned. And, conversely, you need to add lactic acid products to your diet, namely: natural kefir and yogurt.

    After the end of antibiotic therapy, you need to continue using probiotics. The fact is that you need to take probiotics long time- this is the only way to achieve colonization of the intestines beneficial bacteria and restoration of normal biocenosis. On average, the duration of use of probiotics is a month, but if necessary, the course of treatment can be extended.

    Valeria Grigorova, doctor, medical columnist
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