Did you know that a prescription of antibiotics, orally or intravenously, can alter your gut bacteria by as much as tenfold? This can have serious health consequences so:

1. Make sure you need an antibiotic before you take it.

2. Have a plan to repair the damage antibiotics do to your normal and healthy gut bacteria.

According to the Centers for Disease Control, of the millions of antibiotic prescriptions given annually, up to a third may be unnecessary. Common colds, coughs, flu, sinusitis, bronchitis, earaches, sore throats are usually due to viruses, not bacteria. They usually do not require or respond to antibiotics. An antibiotic stewardship program involves both physicians and other health care providers partnering with our patients to avoid antibiotic use for problems not requiring them. This approach can save lives by preventing allergic reactions, side effects like diarrhea and other gut problems, and helping to reduce the rising tide of antibiotic resistance.

Your responsibility is not to pressure your health care provider to give an antibiotic when it isn’t indicated.

But if you need an antibiotic for a significant infection, by all means take it as prescribed. But be aware of the collateral damage it may cause to your microbiome, the normal bacteria inhabiting your body and keeping it in balance.

Children may be particularly vulnerable to alterations in their microbiome from early use of antibiotics. Studies have shown decreases in neurocognitive outcomes and an increase in asthma. Increased obesity and weight gain and even septic shock have been reported in both children and adults.

To help your gut recover after antibiotic treatment take a formulation of mixed species of probiotics rather than a monoculture of one type. Take them two hours away from antibiotics and continue for three to four weeks. These are available at your health food store. Saccharomyces boulardii is a specific type of probiotic that helps resist yeast overgrowth and toxic Clostridium difficile.

Taking probiotic, fermented foods like yogurt, kefir, kimchee, tofu, miso, sauerkraut and others will help your gut repopulate itself with healthful bacteria. Fish oil, zinc, vitamin A, and glutamine can help gut repair. Plant-based medicines like oregano oil, tea tree oil, or pau d’arco can help get rid of unwanted yeast overgrowth.

Certain other foods, so-called prebiotics serve as a substrate food for your body’s native bacteria to regain ground after being damaged from an antibiotic nuking. These include high fiber fruits or vegetables, apples, bananas, asparagus, chicory, garlic, onions, eggplant, legumes, sweet potatoes and other root plants.

When I prescribe an antibiotic for a patient, I always at least consider or recommend that they take a probiotic. I learned this early on in my practice of holistic medicine when women commonly asked me for an antifungal cream to treat their inevitable vaginal yeast infection after an antibiotic course. Others got around this issue by taking probiotic rich yogurt.

So the bottom line is to be aware of the both the benefits and hazards of antibiotics and how to prevent or treat the unwanted damage to your healthy gut bacteria.