ANTIBIOTICS AND PROBIOTICS

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1 ANTIBIOTICS AND PROBIOTICS Information Leaflet Your Health. Our Priority.

2 Page 2 of 6 Antibiotics can upset the healthy bacteria in the gut and cause diarrhoea. Sometimes this diarrhoea can be due to Clostridium difficile, (a bacteria that can get into the gut when other good bacteria have been killed off by the antibiotics). What are probiotics? Probiotics are food ingredients found in products such as fermented milk drinks or yoghurts that contain good bacteria that reach the gut alive in sufficient amounts to benefit the body and maintain a healthy digestive system. Example of a probiotic drink Yakult and Actimel are examples of probiotic fermented milk drinks, which mean they contain live bacteria which are beneficial to you. These are available from most supermarkets. Other brands of probiotic drinks are also available and suitable ones include supermarket own brands. Why have I been advised to have/be given a probiotic drink? Studies have shown that probiotics may be helpful in reducing the risk of patients developing Clostridium difficile (C.difficile) diarrhoea, particularly when they are taking antibiotics. What is Clostridium difficile? Clostridium difficile or C.difficile is a bacteria which is occasionally found in the gut which can become harmful due to other good bacteria being killed off by the antibiotics. It may produce an infection and symptoms in the bowel if allowed to overgrow. C.difficile is usually kept under control by the other bacteria that normally live in the gut that are essential for maintaining good health. Symptoms of an active C.difficile infection usually include diarrhoea.

3 Page 3 of 6 Who gets Clostridium difficile? The infection usually occurs after someone has taken antibiotics to treat another illness. Antibiotics disturb the bacteria normally found in the gut that usually keep C.difficile out of the gut or under control, thereby allowing it to multiply. It then produces poisons (toxins) which can lead to diarrhoea and severe inflammation of the bowel. Although anyone is susceptible to C.difficile, elderly patients who have been treated with antibiotics are most at risk. How does a probiotic drink help to prevent Clostridium difficile causing infection? Drinking a probiotic can help restore the levels of good bacteria that are normally found in a healthy person s gut. This is especially useful for replacing the good bacteria that a patient may lose when taking antibiotics. This reduces the risk of C.difficile taking a hold in the gut and may also reduce the risk of a recurring infection following a C.difficile infection. Are there any patients who should not be taking probiotic drinks? It is not recommended for patients who have a severe lactose intolerance; allergy to cow s milk; patients with pancreatitis; immunocompromised patients (neutropenic or on chemotherapy). If in doubt about whether you should have it, please ask your doctor. Diabetic patients If you are diabetic then you should take a light version of the probiotic drink which will be suitable. Is all diarrhoea associated with taking antibiotics always caused by Clostridium difficile? No, a common side effect of some antibiotics is diarrhoea that is not caused by C.difficile. These diarrhoeal illnesses are usually much less

4 Page 4 of 6 severe and for a shorter duration. This type of diarrhoea may also be reduced by a probiotic drink. What should I do if I develop diarrhoea? In hospital you should inform a nurse or doctor and they will arrange for a specimen of your diarrhoea to be tested. If at home you should contact your GP who can also arrange for a test if appropriate. Can patients that already have Clostridium difficile diarrhoea take probiotic drinks or other probiotics? Yes, probiotic drinks may have a useful role in shortening the duration of a C.difficile diarrhoeal illness. How can Clostridium difficile infection be treated? If possible the antibiotics responsible for causing the C.difficile infection are stopped (unless it is important to continue them for another reason). Patients are then usually started on antibiotics that are effective at treating the C.difficile infection itself. The doctor responsible for your treatment will make this decision. Antibiotics that are less likely to cause C.difficile may be started to replace the original antibiotics if necessary. How often and how much probiotic drinks should I be taking daily? It is recommended that a bottle of probiotic drink, be taken daily from the time antibiotics are started and continue for a week after the antibiotic course finishes. Probiotics should not be taken at the same time of day as oral antibiotics as this may reduce effectiveness. Where can I get probiotic drinks from? You may be advised to continue taking probiotic drinks after discharge from hospital. Probiotic drinks are not a medicine and will not be supplied on any take home prescription. They will NOT be prescribed

5 Page 5 of 6 by your General Practitioner. They can be purchased from most supermarkets. How do I store probiotic drinks? Probiotic drinks should be stored in the refrigerator to preserve its qualities but it should not be frozen. It is a fresh dairy product that should be consumed before its use-by-date. Where can I get further advice? Your GP Your hospital doctors / nurses Hospital Infection Prevention & Control Team ( ) Health Protection & Control of Infection Unit (Community) Your Pharmacist Contact Us For more information, please contact: Infection Prevention Team (Hospital queries) (8.30 to Monday to Friday) Or Infection.prevention@stockport.nhs.uk (hospital queries) Health Protection & Control of Infection Unit (Community queries) (8.30 to Monday to Friday) Or healthprotection@stockport.gov.uk (community queries)

6 Page 6 of 6 If you would like this leaflet in a different format, for example, in large print, or on audiotape, or for people with learning disabilities, please contact: Patient and Customer Services, Poplar Suite, Stepping Hill Hospital. Tel: Information Leaflet. PCS@stockport.nhs.uk. Our smoke free policy Smoking is not allowed anywhere on our sites. Please read our leaflet 'Policy on Smoke Free NHS Premises' to find out more. Leaflet number LAB95 Publication date November 2013 Review date November 2015 Department Infection Prevention Location Stepping Hill Hospital