{"id":60346,"date":"2023-09-15T10:00:42","date_gmt":"2023-09-15T14:00:42","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=60346"},"modified":"2025-04-08T13:56:34","modified_gmt":"2025-04-08T17:56:34","slug":"diarrhea-from-antibiotics","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/diarrhea-from-antibiotics\/","title":{"rendered":"Can antibiotics cause diarrhea?"},"content":{"rendered":"<p><span style=\"font-weight: 400;\">If you have ever gone to the doctor for an infection, you have probably been prescribed antibiotic treatment. These medications are formulated to kill harmful bacteria that cause infections, and like most medications, antibiotics come with a risk of side effects.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">One of the most common complaints is antibiotic-induced diarrhea. Generally, diarrhea clears up after you stop taking the antibiotics. But while you\u2019re on antibiotics, you may wonder how to stop yourself from running to the toilet and if you should tell your doctor what&#8217;s happening. You may also wonder whether you can discontinue your antibiotics to resolve the problem.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">To help you navigate this uncomfortable side effect, three healthcare professionals explain why antibiotics cause diarrhea, the worst antibiotics for diarrhea, and how to stop diarrhea from antibiotics.<\/span><\/p>\n<h2 id=\"can-antibiotics-cause-diarrhea\"><span style=\"font-weight: 400;\">Can antibiotics cause diarrhea?\u00a0<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">It&#8217;s not unusual for antibiotics to cause loose stools, says <\/span><a href=\"https:\/\/www.harborhealth.com\/clinicians\/necessitatibus-magni-distinctio\"><span style=\"font-weight: 400;\">Jodie Pepin, Pharm.D<\/span><\/a><span style=\"font-weight: 400;\">., the clinical pharmacy program director at Harbor Health. <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC6067053\"><span style=\"font-weight: 400;\">Research<\/span><\/a><span style=\"font-weight: 400;\"> suggests that 5% to 35% of people taking antibiotics develop antibiotic-associated diarrhea.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Dr. Pepin says there&#8217;s a\u00a0 reason these medicines can send you to the toilet: <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/tag\/antibiotics\/\"><span style=\"font-weight: 400;\">Antibiotics<\/span><\/a><span style=\"font-weight: 400;\"> disrupt the natural balance of good and bad intestinal bacteria. When an antibiotic kills the good bacteria in your gut, your body can&#8217;t process poop into its fully-formed, semi-soft consistency. However, the risk of diarrhea varies depending on the type of antibiotic.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">&#8220;Different classes of antibiotics treat different types of bacteria,&#8221; says <\/span><a href=\"https:\/\/www.thepublichealthpharmacist.com\/about\"><span style=\"font-weight: 400;\">Christina M. Madison, Pharm.D.<\/span><\/a><span style=\"font-weight: 400;\">, FCCP, founder of The Public Health Pharmacist in Las Vegas.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">&#8220;When we are unsure what the infection is being caused by, we typically use what&#8217;s called &#8217;empiric&#8217; therapy with a &#8216;broad spectrum&#8217; antibiotic,&#8221; she says. These broad-spectrum antibiotics kill good and bad bacteria, which might temporarily impede your body&#8217;s ability to make fully-formed stools. The result? Diarrhea.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">According to the <\/span><a href=\"https:\/\/www.mayoclinic.org\/diseases-conditions\/antibiotic-associated-diarrhea\/symptoms-causes\/syc-20352231\"><span style=\"font-weight: 400;\">Mayo Clinic<\/span><\/a><span style=\"font-weight: 400;\">, antibiotic-induced diarrhea typically starts about a week after the first antibiotic dose.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Don&#8217;t stop taking your prescribed antibiotic if you experience this unpleasant side effect. Instead, report the frequency and severity to your healthcare provider to help you navigate your options, says <\/span><a href=\"https:\/\/regeneratemedicalconcierge.com\/about\/\"><span style=\"font-weight: 400;\">Minesh Amin, DO<\/span><\/a><span style=\"font-weight: 400;\">, medical director at Regenerate Medical Concierge in Henderson, Nevada.\u00a0<\/span><\/p>\n<h2 id=\"which-antibiotics-cause-diarrhea\"><span style=\"font-weight: 400;\">Which antibiotics cause diarrhea?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Most antibiotics have the potential to cause diarrhea. However, Dr. Madison says &#8220;targeted&#8221; antibiotics\u2014drugs that are effective against just one bacterial type\u2014are less likely to impede healthy stool formation. Broad-spectrum antibiotics designed to kill a wide variety of microorganisms are hardest on the digestive system. But the likelihood of diarrhea occurring\u00a0 isn\u2019t necessarily what your provider considers before prescribing the antibiotic.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u201cWe can never select an antibiotic with the intent to try and avoid antibiotic-induced diarrhea,&#8221; says Dr. Amin. &#8220;The choice of antibiotic is always based on the greatest likelihood of eradicating the active infection,&#8221; he explains.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Antibiotic drug classes associated with the most significant risk of antibiotic-induced diarrhea include:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Lincosamides<\/b><span style=\"font-weight: 400;\"> (like clindamycin) pose the highest risk of antibiotic-induced bacteria, according to a <\/span><a href=\"https:\/\/www.medsci.org\/v16p0630.htm\"><span style=\"font-weight: 400;\">meta-analysis<\/span><\/a><span style=\"font-weight: 400;\"> of more than 2 million reports of reactions to antibiotics.\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Beta-lactams,<\/b><span style=\"font-weight: 400;\"> such as amoxicillin, <\/span><a href=\"https:\/\/www.singlecare.com\/drug-classes\/penicillins\"><span style=\"font-weight: 400;\">penicillin<\/span><\/a><span style=\"font-weight: 400;\">, <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/ampicillin\"><span style=\"font-weight: 400;\">ampicillin<\/span><\/a><span style=\"font-weight: 400;\">, and <\/span><a href=\"https:\/\/www.singlecare.com\/drug-classes\/cephalosporins\"><span style=\"font-weight: 400;\">cephalosporins<\/span><\/a><span style=\"font-weight: 400;\"> (cephalexin, cefpodoxime, and cefdinir, for example)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/doi.org\/10.1002\/14651858.CD011825.pub2\"><b>Macrolides<\/b><\/a><b>, <\/b><span style=\"font-weight: 400;\">such as <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/erythromycin\"><span style=\"font-weight: 400;\">erythromycin<\/span><\/a><span style=\"font-weight: 400;\">, <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/clarithromycin\"><span style=\"font-weight: 400;\">clarithromycin<\/span><\/a><span style=\"font-weight: 400;\">, and <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/azithromycin\"><span style=\"font-weight: 400;\">azithromycin<\/span><\/a><span style=\"font-weight: 400;\"> (though the latter has a slightly lower likelihood of disrupting gut bacteria, according to Dr. Madison)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Fluoroquinolones,<\/b><span style=\"font-weight: 400;\"> such as <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/ciprofloxacin\"><span style=\"font-weight: 400;\">ciprofloxacin<\/span><\/a><span style=\"font-weight: 400;\"> and <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/levofloxacin\"><span style=\"font-weight: 400;\">levofloxacin<\/span><\/a><span style=\"font-weight: 400;\">, which Dr. Amin says are commonly prescribed for urinary tract infections and respiratory tract infections<\/span><\/li>\n<\/ul>\n<h3 id=\"risk-of-c-difficile-associated-diarrhea\"><span style=\"font-weight: 400;\">Risk of C. difficile-associated diarrhea<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">In some cases, multiple courses of antibiotics can cause a bacteria called <\/span><i><span style=\"font-weight: 400;\">Clostridioides difficile<\/span><\/i><span style=\"font-weight: 400;\"> (<\/span><a href=\"https:\/\/www.singlecare.com\/conditions\/clostridium-difficile-treatment-and-medications\"><span style=\"font-weight: 400;\">C. diff<\/span><\/a><span style=\"font-weight: 400;\">) to run rampant in the colon.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">&#8220;When it is allowed to overgrow \u2026 <\/span><i><span style=\"font-weight: 400;\">C. diff<\/span><\/i><span style=\"font-weight: 400;\"> releases a toxin that damages the lining of our gut,&#8221; Dr. Pepin explains. &#8220;The result of this is an infection that causes severe diarrhea and inflammation.\u201d<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Unlike other antibiotic-induced diarrhea, <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/antibiotics-that-cause-c-diff\/\"><i><span style=\"font-weight: 400;\">C. diff<\/span><\/i><\/a> <span style=\"font-weight: 400;\">is highly contagious and dangerous, making it a concern among hospitalized patients. About <\/span><a href=\"https:\/\/www.cdc.gov\/media\/releases\/2015\/p0225-clostridium-difficile.html\"><span style=\"font-weight: 400;\">9% of adults 65 or older with a <\/span><i><span style=\"font-weight: 400;\">C. difficile <\/span><\/i><span style=\"font-weight: 400;\">infection<\/span><\/a><span style=\"font-weight: 400;\"> die within 30 days of diagnosis. Dr. Pepin says good hand-washing hygiene is essential to stopping the spread.\u00a0<\/span><\/p>\n<h2 id=\"symptoms-of-antibiotic-associated-diarrhea\"><span style=\"font-weight: 400;\">Symptoms of antibiotic-associated diarrhea<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Most cases of <\/span><a href=\"https:\/\/www.mayoclinic.org\/diseases-conditions\/antibiotic-associated-diarrhea\/symptoms-causes\/syc-20352231\"><span style=\"font-weight: 400;\">antibiotic-associated diarrhea<\/span><\/a><span style=\"font-weight: 400;\"> are mild, and symptoms include:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Loose, watery stools<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Frequent bowel movements (three times per day or more)<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Symptoms of <\/span><i><span style=\"font-weight: 400;\">C. diff<\/span><\/i><span style=\"font-weight: 400;\"> infection are usually more severe. They include:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Loose, watery stools that are often uncontrollable<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Frequent bowel movements<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Abdominal pain<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Gastrointestinal cramps<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Nausea<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Poor appetite<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.singlecare.com\/blog\/fever-temperature\/\"><span style=\"font-weight: 400;\">Fever<\/span><\/a><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">If you show signs of a <\/span><i><span style=\"font-weight: 400;\">C. difficile<\/span><\/i><span style=\"font-weight: 400;\"> infection, consult a healthcare professional immediately.\u00a0<\/span><\/p>\n<h2 id=\"what-should-i-eat-if-i-have-diarrhea-from-antibiotics\"><span style=\"font-weight: 400;\">What should I eat if I have diarrhea from antibiotics?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Dr. Amin suggests eating more starchy foods because they are easy to digest. Additionally, probiotic-rich foods can help repopulate your gut with good bacteria. He also emphasizes the importance of staying hydrated.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">&#8220;One of the most common recommendations when experiencing antibiotic-induced diarrhea is the BRAT diet. This includes bananas, rice, applesauce, and toast,&#8221; he says. Dr. Amin also suggests eating yogurt for the following reasons:\u00a0<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>It contains probiotics. <\/b><span style=\"font-weight: 400;\">Yogurt&#8217;s probiotics can help offset the antibiotics&#8217; eradication of good gut bacteria. Read the label to ensure you buy yogurt containing live active cultures.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>It can soothe gut inflammation. <\/b><span style=\"font-weight: 400;\">Plain yogurt can have a cooling effect on the gut, which might help settle your stomach after antibiotics.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>It contains essential nutrients.<\/b><span style=\"font-weight: 400;\"> &#8220;Yogurt is packed with essential nutrients such as calcium, B-12, and vitamin D,&#8221; Dr. Amin says.<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Drink fluids with electrolytes. <\/span><a href=\"https:\/\/www.niddk.nih.gov\/health-information\/digestive-diseases\/diarrhea\/symptoms-causes\"><span style=\"font-weight: 400;\">Dehydration<\/span><\/a><span style=\"font-weight: 400;\"> is a severe risk for anyone with diarrhea. Watery diarrhea means that many of the fluids you consume go straight into the toilet instead of being absorbed by your body. When fluid is lost, you also lose electrolytes (essential minerals like sodium, potassium, and magnesium). Drs. Amin and Pepin suggest rehydration with electrolyte drinks, such as Pedialyte, Gatorade, Powerade, and broths.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">&#8220;Electrolyte solutions in general are far superior to water when a person has diarrhea because the electrolytes allow quicker absorption of the water into the body,&#8221; Dr. Amin says.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">There are also foods to avoid when experiencing antibiotic-induced diarrhea. Dr. Pepin recommends staying away from red meat, while Dr. Amin says spicy and greasy foods can worsen diarrhea. He also suggests limiting caffeine and alcohol, which stimulate the gut and increase bowel movements.<\/span><\/p>\n<h2 id=\"how-to-stop-diarrhea-from-antibiotics\"><span style=\"font-weight: 400;\">How to stop diarrhea from antibiotics<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Antibiotic-induced diarrhea will often go away on its own after a few days. However, there are self-care measures to help relieve discomfort while you wait for it to clear up. Diarrhea management tips from the experts at the <\/span><a href=\"https:\/\/health.clevelandclinic.org\/how-to-prevent-diarrhea-while-you-take-antibiotics\/\"><span style=\"font-weight: 400;\">Cleveland Clinic<\/span><\/a><span style=\"font-weight: 400;\"> include:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Eat bland, low-fiber, starchy foods until the diarrhea resolves.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Avoid fried and spicy foods.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.singlecare.com\/blog\/alcohol-with-antibiotics\/\"><span style=\"font-weight: 400;\">Avoid alcohol<\/span><\/a><span style=\"font-weight: 400;\"> and caffeine while taking antibiotics.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.singlecare.com\/blog\/taking-probiotics-with-antibiotics\/\"><span style=\"font-weight: 400;\">Take probiotics<\/span><\/a><span style=\"font-weight: 400;\"> to rebalance gut bacteria and stop the diarrhea.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Drink plenty of water, fruit juices, and electrolyte drinks to stay hydrated.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Consult your healthcare provider about anti-diarrheal medications such as loperamide (Imodium A-D) or possibly <\/span><span style=\"font-weight: 400;\">Pepto-Bismol<\/span><span style=\"font-weight: 400;\">.<\/span><\/li>\n<\/ul>\n<p><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3424311\/\"><span style=\"font-weight: 400;\">Clinical trials<\/span><\/a><span style=\"font-weight: 400;\"> suggest that Lactobacillus rhamnosus GG (LGG) and Saccharomyces boulardii (S. boulardii) are the best probiotics for diarrhea caused by antibiotics. These strains are widely available in oral probiotic supplements.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">&#8220;One to two loose stools per day is common from antibiotic therapy,&#8221; Dr. Madison says. &#8220;If you are experiencing significant side effects from your medication therapy, you should reach out to the prescribing provider before discontinuing therapy.&#8221;<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Call your healthcare provider immediately if you experience additional symptoms such as weakness, fever, or loss of appetite. &#8220;A doctor can do a stool sample to test for <\/span><i><span style=\"font-weight: 400;\">C. diff<\/span><\/i><span style=\"font-weight: 400;\"> and treat it quickly,&#8221; Dr. Pepin says.<\/span><\/p>\n<h2 id=\"how-to-prevent-diarrhea-from-antibiotics\"><span style=\"font-weight: 400;\">How to prevent diarrhea from antibiotics<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">First, only take antibiotics when prescribed by a healthcare professional to treat a bacterial infection, says Dr. Madison. Antibiotics are ineffective against viruses such as the common cold or seasonal flu.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Beyond that, prevention of antibiotic-associated diarrhea involves the same practices as treatment options:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Take the right drug for the right bug. <\/b><span style=\"font-weight: 400;\">Dr.<\/span> <span style=\"font-weight: 400;\">Madison suggests taking the most targeted treatment for your infection versus a broad-spectrum antibiotic. This reduces the chance of disrupting your gut microbiome.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.singlecare.com\/blog\/probiotics-do-they-work\/\"><b>Add a probiotic<\/b><\/a><b>. <\/b><span style=\"font-weight: 400;\">Dr. Amin says nourishing your gut with good bacteria can help prevent antibiotic-induced diarrhea and treat it when it occurs.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Keep protecting your digestive tract after the antibiotics are finished. <\/b><span style=\"font-weight: 400;\">Stave off post-antibiotic diarrhea by eating yogurt with live active cultures or taking oral probiotic supplements for about a week after <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/finish-antibiotics\/\"><span style=\"font-weight: 400;\">completing your antibiotic course<\/span><\/a><span style=\"font-weight: 400;\">, recommends Dr. Pepin.<\/span><\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>If you have ever gone to the doctor for an infection, you have probably been prescribed antibiotic treatment. These medications are formulated to kill harmful bacteria that cause infections, and like most medications, antibiotics come with a risk of side effects.\u00a0 One of the most common complaints is antibiotic-induced diarrhea. Generally, diarrhea clears up after [&hellip;]<\/p>\n","protected":false},"author":145,"featured_media":58572,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[8029],"tags":[715,20948,16414],"coauthors":[20942],"class_list":["post-60346","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health-education","tag-antibiotics","tag-diarrhea","tag-digestive-health","wpautop"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.4 (Yoast SEO v27.4) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Can antibiotics cause diarrhea?<\/title>\n<meta name=\"description\" content=\"Up to 35% of people will experience diarrhea from antibiotics. 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