According to the Merriam Webster dictionary, an antibiotic is “a substance produced by or a semisynthetic substance derived from a microorganism and able in dilute solution to inhibit or kill another microorganism.” What it fails to mention, however, is that antibiotics not only kill the bad bacteria—they also kill the good, making the case for avoiding antibiotics. 

Does this mean you need to be avoiding antibiotics? Not necessarily—but antibiotics definitely aren’t something you want to abuse. I treat so many patients who are already on an antibiotic when they really don’t need to be.

In my opinion, an antibiotic makes it more difficult to achieve a correct diagnosis. They make the patient feel better, but that means we can’t find the problem. The infection then lingers even longer, until it resurfaces and we can actually make the diagnosis. Other times, the patient is not in any pain but they may have what is called a sinus tract – which is your body’s natural antibiotic.

When You CAN Get By with Avoiding Antibiotics

Have you ever seen one of these?

Your body creates a pimple on the gum and shoots out the infection on its own. It’s the body’s way of finding that portal of least resistance and stabilizing the infection so it doesn’t accumulate in the body. In this case, the patient wouldn’t need an antibiotic, because they aren’t in pain unless they press on the area.  They may swallow it (yuck!), but that’s okay.

Antibiotics Are Not Pain Relievers

Doctors often prescribe antibiotics as pain relievers. But that’s not what antibiotics are for! As medical professionals, we need to use pain relievers for pain and antibiotics for infections.  If you abuse an antibiotic, the body begins to develop a resistance, and the next time you need an antibiotic, it may not work as effectively.

Unfortunately, many patients are developing allergies to antibiotics. They also contract colitis as a response because the antibiotic wipes out all the good bacteria from the gut.  It is important to note that we’re not just seeing colitis as a result of Clindamycin anymore—we are now getting cases from simpler antibiotics like amoxicillin.

So what’s my point? We should be avoiding antibiotics as a solution for pain relief. It’s not helping anyone—in fact, it’s hurting them. 

Whenever you’re taking an antibiotic, always supplement with a probiotic to get “the good guys” back. When we prescribe antibiotics, we recommend a paired probiotic in pill form to replenish the good bacteria that may otherwise be wiped out.

For example, when we prescribe clindamycin for more serious infections, we ask our patients to also pick up Saccharomyces boulardii probiotic.

Probiotics for Your Diet

Some whole foods are natural probiotics. There are many super healthy probiotic foods that you can recommend to your patients if they need to take antibiotics, which help bring balance to the gut.

Yogurt

Yogurt is one of the best sources of probiotics, which, again, are those friendly bacteria that can improve your health. It comes from fermenting milk with friendly bacteria, mainly lactic acid bacteria and bifidobacteria. In children, yogurt may help reduce the diarrhea caused by antibiotics. However, keep in mind that not all yogurt contains live probiotics. In some cases, processing kills the live bacteria. For this reason, make sure to choose yogurt with active or live cultures. I know we can’t get by with avoiding antibiotics ALL the time, but we CAN recommend that our patients eat lots of yogurt!

Kefir

Kefir is a fermented probiotic milk drink made by adding kefir grains to cow’s or goat’s milk. Its grains are not cereal grains, but are cultures of lactic acid bacteria and yeast that look a bit like cauliflower. The name kefir allegedly comes from the Turkish word keyif, which means “feeling good” after eating. Sure enough, kefir has various health benefits: it can improve bone health, help with some digestive problems, and protect against infections. While yogurt is the best known probiotic food in the Western diet, kefir is a better source. It contains several major strains of friendly bacteria and yeast, making it a diverse and potent probiotic.

Sauerkraut

Sauerkraut is finely shredded cabbage fermented with lactic acid bacteria. In addition to its probiotic qualities, sauerkraut is rich in fiber, as well as vitamins C, B and K. It is also high in sodium and contains iron and manganese. However, make sure to choose unpasteurized sauerkraut. Pasteurization kills the live and active bacteria.

Tempeh

Tempeh is a fermented soybean product. It forms a firm patty, and it tastes pretty good—similar to a mushroom. The fermentation process has some surprising effects on tempeh’s nutritional profile. It lowers the amount of phytic acid, which may increase the amount of minerals the body is able to absorb from tempeh. Interestingly, the bacteria also produce vitamin B12, a nutrient that soybeans do not contain. Vitamin B12 is mainly found in animal foods, such as meat, fish, dairy products and eggs. This makes tempeh a great probiotic choice for vegans.

Kimchi

Kimchi is a spicy fermented Korean side dish. Cabbage is usually the main ingredient, but kimchi can also consist of other vegetables. Kimchi contains the lactic acid bacteria Lactobacillus kimchii, as well as other lactic acid bacteria that may benefit digestive health. Cabbage kimchi is high in some vitamins and minerals, including vitamin K, riboflavin (vitamin B2) and iron. So if you have patients that are nervous about taking certain meds because they’re avoiding antibiotics (but they really NEED them), then have some fun and recommend this. (But make sure they know “It’ll put hair on their chest”… if you haven’t tried kimchi, you should know it has a very strong flavor!)

Miso

Miso is a Japanese seasoning made by fermenting soybeans with salt and a type of fungus called koji. This paste is a main ingredient in miso soup, a popular breakfast food in Japan. Miso is typically salty, and you can buy it in many varieties, such as white, yellow, red and brown. Miso is a good source of protein and fiber. It is also high in various vitamins, minerals and phytonutrients, including vitamin K, manganese and copper.

Kombucha

Kombucha is a popular black or green tea drink fermented with a friendly colony of bacteria and yeast. People all over the world drink it, especially in Asia. There are plenty of Internet claims about the potential health effects of kombucha tea; however, high-quality evidence on kombucha is scant. The studies that exist are animal and test tube studies, and the results may not apply to humans. Still, because of its fermented nature, kombucha probably has probiotic health benefits.

Pickles

Pickles (also known as gherkins) are cucumbers that have been pickled in a solution of salt and water. They ferment for some time, using their own naturally present lactic acid bacteria. This process is what makes them sour. Pickled cucumbers are a great source of healthy probiotic bacteria, which may improve digestive health. They are low in calories and are a good source of vitamin K, an essential nutrient for blood clotting. Pickles also tend to be high in sodium. It is important to note that pickles made with vinegar do not contain live probiotics.

Traditional Buttermilk

“Buttermilk” refers to a range of fermented dairy drinks. However, there are two main types: traditional and cultured. Traditional buttermilk is simply the leftover liquid from making butter. Only this version, which some people call Grandma’s probiotic, contains friendly bacteria. Cultured buttermilk, available in American supermarkets, generally does not have any probiotic benefits. Buttermilk is low in fat and calories, but contains several important vitamins and minerals, such as vitamin B12, riboflavin, calcium and phosphorus.

Some Types of Cheese

Although most types of cheese are fermented, not all of them contain probiotics. Be sure to to look for live and active cultures on the food labels. The good bacteria survive the aging process in some cheeses, including Gouda, mozzarella, cheddar, and cottage cheese. Cheese is highly nutritious, and is a very good source of protein. It is also rich in key vitamins and minerals, including calcium, vitamin B12, phosphorus, and selenium.

Doctors sometimes feel pressure from their patients to prescribe an antibiotic. We need to change this mindset and educate our patients, because an antibiotic isn’t always the best solution.

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