Do probiotics during antibiotics cause disease risk?
The short answer is no—the evidence does not show that taking probiotics alongside antibiotics increases your risk of disease. A 2023 systematic review and meta-analysis of 15 randomized controlled trials found no significant difference in gut microbiome diversity between people who took probiotics with antibiotics and those who did not [1]. This means probiotics did not disrupt the microbiome further or cause harm. Similarly, a 2024 field study on honey bees—a model for gut microbiome research—found that probiotics did not increase disease markers or worsen antibiotic-induced dysbiosis [3]. So, across human and animal studies, probiotics are not a cause of disease risk.
Are probiotics just a marker of something else, or do they actually help?
The evidence is mixed, but probiotics are not a reliable marker of better outcomes—they either help in specific situations or do nothing. In a 2022 study of 104 men with prostate infections, adding a specific probiotic blend (Enterococcus faecium and Saccharomyces boulardii) to antibiotics led to a 76.2% infection eradication rate, compared to 50% with antibiotics alone—a statistically significant improvement [2]. However, a 2024 study on 128 women with recurrent urinary tract infections found that adding vaginal probiotics reduced recurrence from 28.1% to 15.6%, but this difference was not statistically significant [4]. This suggests probiotics may help in some contexts (like male prostate infections) but not in others (like female UTIs), and they are not a consistent marker of anything.
Are there any situations where probiotics during antibiotics are beneficial?
Yes, but the benefits appear limited to specific conditions and formulations. The 2022 prostate infection study showed that a targeted probiotic combination significantly reduced persistent infections [2]. In a 2022 mouse study of nerve injury, probiotics with butyrate-producing bacteria partially restored gut microbiota and improved functional recovery after antibiotic-induced dysbiosis [5]. This suggests that probiotics may help in recovery from nerve damage or in male reproductive infections, but not for general gut health or preventing UTIs. The key takeaway: if you are taking antibiotics for a specific infection, a tailored probiotic might help, but for routine antibiotic use, the evidence does not support a general benefit.
About These Sources
This answer is built on 5 peer-reviewed studies — published from 2022 to 2024, 2 from 2024 or later, 2 in Q1 journals, collectively cited 107 times — selected as the most relevant from 6 studies that passed quality screening, drawn from 64 papers retrieved from a database of over 500 million.
Sources used in this answer
Probiotic supplementation during antibiotic treatment is unjustified in maintaining the gut microbiome diversity: a systematic review and meta-analysis
This 2023 systematic review and meta-analysis of 15 randomized controlled trials found no significant difference in gut microbiome diversity (Shannon, Chao1, observed OTUs) between patients taking probiotics with antibiotics and those taking antibiotics alone, concluding probiotics are not justified for maintaining diversity.
Association of Probiotic Treatment With Antibiotics in Male Accessory Gland Infections
In a 2022 study of 104 men with prostate infections, adding a specific probiotic (Enterococcus faecium and Saccharomyces boulardii) to antibiotics led to 76.2% infection eradication vs. 50% with antibiotics alone (p < .05), showing a significant benefit in this context.
A longitudinal field study of commercial honey bees shows that non-native probiotics do not rescue antibiotic treatment, and are generally not beneficial
A 2024 field study on honey bees found that probiotics did not affect gut microbiome composition or disease markers, and did not rescue antibiotic-induced dysbiosis, highlighting a lack of probiotic effect in this agricultural setting.
Effectiveness of adding vaginal probiotic to standard antibiotic treatment in recurrent urinary tract infections
A 2024 study on 128 women with recurrent UTIs found that adding vaginal probiotics reduced recurrence from 28.1% to 15.6%, but this difference was not statistically significant, indicating no clear benefit.
Altered gut microbiota composition with antibiotic treatment impairs functional recovery after traumatic peripheral nerve crush injury in mice: effects of probiotics with butyrate producing bacteria
A 2022 mouse study showed that antibiotics impaired functional recovery after nerve crush injury, but probiotics with butyrate-producing bacteria partially restored gut microbiota and improved recovery, indicating potential neurological benefits.