If a patient takes probiotics while on antibiotic therapy, will the antibiotics just kill off the probiotics? How long should probiotics be given? Finally, are nonrefrigerated probiotics any more or less effective than the refrigerated brands?—NANCY DAY, CPNP, Gainesville, Fla.

Probiotics have gained popularity in the past few years as adjunctive therapy to prevent various GI problems related to antibiotic use. As with many medications, antibiotics should not be taken with four hours of probiotics to prevent the risk of weakening the antibiotic effect. If possible, probiotics should be started several days prior to antibiotics and continue for up to a month afterward. There are many different brands and forms of probiotic supplements, and the refrigeration that was originally necessary is no longer indicated on many of the available and effective forms. For more information, see the May 2009 issue of The Clinical Advisor and the National Center for Complementary and Alternative Medicine’s website (accessed February 15, 2011).—Sherril Sego, FNP-C, DNP (149-12)

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