Do Probiotics Restore Gut Microbiota After Antibiotic Use?

A new review published in Nature Reviews Gastroenterology & Hepatology examined current evidence on probiotics’ role in gut microbiota restoration. The study, authored by experts in clinical medicine, microbiome science, and probiotic research, highlights a lack of robust research addressing this specific question.

According to the study, antibiotics are essential for treating bacterial infections but often disrupt the gut microbiota, reducing its diversity and causing side effects like diarrhea and Clostridioides difficile colitis. Probiotics are commonly used alongside antibiotics to alleviate these issues, but their ability to restore the gut microbiota to its pre-antibiotic state remains uncertain.

“Restoring gut microbiota with probiotics during antibiotic use is an important topic,” said lead author Prof. Hania Szajewska, MD, PhD. “Although many studies include microbiome-related endpoints, robust research specifically targeting the restoration of gut microbiota as a primary outcome remains limited.”

Some studies suggest that probiotics may mitigate microbiota changes caused by antibiotics, but the study’s authors explained that evidence on full restoration is rare and often limited by methodological issues. The review found that while probiotics can reduce clinical symptoms like antibiotic-associated diarrhea, their effects on microbiota composition and function are not well understood. “Even though certain probiotics are clearly beneficial… we still don’t know exactly how they achieve this,” added co-lead author Karen Scott, PhD, a professor at the University of Aberdeen in the United Kingdom.

The researchers called for future studies to focus on the unique effects of different antibiotics on the gut microbiota and how specific probiotic strains influence recovery. They also emphasized the need for better tools to measure microbiota disruption and restoration, as current techniques are inconsistent and lack standardization.