Probiotic whilst on Profylaxis antibiotics

[Cheltman]

Hi all

It’s been a while since I’ve posted here but I have query regarding probiotics. I finished the Venetoclax treatment in July 24 but kept getting chest infections. This has led to my consultant putting me on a course of Profylaxis antibiotics (Azithromycin) to see if it prevents further infection. Do you you feel probiotics are ok to take along side to help with the stomach issue side effects (constipation, bloating etc). Thanks

[Poodle2]

Only if your neutrophils are in a normal range. Are you sure your constipation and bloating are due to Azithromycin? Do you eat enough fibre? Dried prunes are great, apples, pears, etc. Do you drink enough water? If your fibre and water intake is low, probiotics won't really solve your issues with constipation and bloating.

[Cheltman in reply to Poodle2]

Hi Poodle2

Thanks for your reply and advice. I feel my fibre intake and fluids are ok as my diet hasn’t changed since starting the Azithromycin course 4 weeks ago. I did have had issues with neutropenia whilst on the Venetoclax but this was resolved by a lower maintenance dose. I guess my concern was if introducing a live bacteria could have contra indications as it would when neutropenic. I most probably being over cautious.

[AussieNeil Partner Administrator in reply to Cheltman]

There is a slight risk of infection with probiotics in those who are immune compromised, so your concern may be warranted. In Infectious complications following probiotic ingestion: a potentially underestimated problem? A systematic review of reports and case series

bmccomplementmedtherapies.b...

there's mentions one case "of sepsis due to B. subtilis in in a 73-year-old man with chronic lymphocytic leukemia who used probiotics before his hospitalization. The same B. subtilis strain, identified by a deoxyribonucleic acid (DNA) amplification technique, was found in the patient’s blood."

Neil

[Cheltman in reply to AussieNeil]

Hi AussieNeil

Thanks for this, I think I may try and be a bit more patient and see if the medication side effects lessen over the next month. I am due back with the consultant mid April and will raise it with him. Thanks again, and once more, for your response and information.👍💚

[Poodle2 in reply to Cheltman]

I think you are right to be checking. I was definitely told not to take them when I was on V+O and neutropenic. I am also on Azithromycin and my neutrophils have been in a normal range since the end of V+O. I drink kefir or have a kefir yoghurt every now and then. I really try to eat fruit and veg and drink 2l a day. I also have some dried prunes (about 5 prunes 1-2x a week). Maybe try the prunes? It won't help with bloating but it will definitely help with constipation. Don't over do it as it can have the opposite effect if you eat too much of them. At least you don't have to worry if you can eat them and it should resolve your constipation? Goof luck 🙏🏻

[Cheltman in reply to Poodle2]

Thanks for the advice Poodle2.I’ll give the prunes a go and see if it helps. 👍

[SofiaDeo in reply to Cheltman]

The thing is, if the antibiotics are changing your own gut flora somewhat, such that you are having gas/constipation, modifying the amount & type of fiber and liquid is a "non drug" way of dealing with this, no? Instead of trying to add different bacteria, which might not be the ones the antibiotics are affecting?

The OTC drugs that are pretty benign & your doc would likely be fine with you trying them, are simethicone (for gas) and a stool softener (for constipation). Both these are used for post-partum patients. Start with the stool softener, the gas may pass easier on its own if the fecal matter starts moving, if you aren't interested in trying foods.