# Taking probiotic with antibiotic



## cynthia (May 9, 2006)

My son has SIBO and we've tried all the usual things that I see many of you have also tried. (SCD, natural antifungals/antibacterials, probiotics, digestive enzymes, Vivonex protocol) Up to now we haven't tried antibiotics and I think it's time to try that too. But I have concerns about his taking antibiotics without also taking a probiotic. When you take antibiotics you're increasing the likelihood of developing a yeast overgrowth in the large intestines, the mouth, etc. So it seems like a good idea to also take a probiotic. But, if you rotated a probiotic with an antibiotic say every 6 hours, wouldn't the antibiotic just be killing off the good bacteria that you just put in your body 5 hours earlier?Cynthia


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## Moises (May 20, 2000)

Cynthia,I did not realize that your son had already tried Vivonex. How long did he take it for and was he (you?) fanatical about ingesting nothing but Vivonex and water?From my (unexpert) reading of the synopses of the research papers Pimentel has published, Vivonex is the gold standard for the treatment of SIBO. His research showed that only 37% of Xifaxan-treated patients showed overall improvement compared to 23% showing improvement in the placebo group. So Xifaxan on did 14% better than a placebo. That doesn't sound like very good odds to me. Of course, that didn't stop me from trying Xifaxan myself.On the other hand, in his book Pimentel said that he had something like an 85% success rate with Vivonex. I don't know what the measure of success was in the Vivonex trials but if the measure was similar to the Xifaxan trial then Vivonex was more than twice as effective as Xifaxan.I would try Vivonex first but I have some serious health concerns and it would require that I prepare for a couple of months before I take Vivonex. But for a normal person I think it makes sense to do Vivonex first because it has the greatest chance for success.As to the antibiotics killing off the yeast antagonists, sure, take a probiotic. Pimentel claims in his book that colonic bacteria double in volume once every 20 minutes. So they grow back rapidly. I just started taking the probiotic called Align that I heard about on this board. I actually take it with my morning Xifaxan. But your suggestion to take them separately makes sense.Have you contacted Dr. Starpoli? Has your son had a breath test? If he took the Vivonex for at least two weeks and he was fanatical about avoiding any other food or drink during that time, I would think that antibiotics are unlikely to be effective. If he were my son, I would try to find the results of a breath test before I had him begin a course of antibiotics. What are his symptoms?


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## cynthia (May 9, 2006)

When my son did the Vivonex he had nothing else but water. He took it for 9 days. And, yes, he did improve. But it's not the magic bullet that it may appear to be. But I think that when it comes to SIBO it takes a long time of constantly killing off the bad bacteria. So that when I look back my son is better than he was 6 months ago and 6 months ago was better than he was the 6 months prior to that. Each "treatment" helps. I'm not sure what Pimental was basing his success rate on. If it was simply that people tested with lower levels on their breath tests, then that makes sense. But if those "successes" were polled personally, I wouldn't think that their symptoms had been totally eradicated.About taking a probiotic with an antibiotic, it still seems to me that the probiotic might interfere with the antibiotic killing off bad bacteria. Does anyone have any suggestions as to how to take them together? Like maybe taking one dose of probiotic every certain number of doses of antibiotic? I know some people don't take their probiotics at all until after the round of antibiotics are done.Thanks.


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