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| Meta Title | Can antibiotics cause diarrhea? |
| Meta Description | Up to 35% of people will experience diarrhea from antibiotics. Learn which antibiotics are more likely to cause diarrhea and how to prevent this side effect. |
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| Boilerpipe Text | Key takeaways
Antibiotics can cause diarrhea by disrupting the gutâs natural balance of good and bad bacteria. Broad-spectrum antibiotics pose a higher risk.
Antibiotic-induced diarrhea typically starts about a week after beginning antibiotic treatment. If you experience diarrhea, consult your healthcare provider before stopping the medication.
Eating bland, starchy foods, staying hydrated, and taking probiotics can help manage antibiotic-induced diarrhea. Itâs also important to avoid spicy, greasy foods and caffeine.
Prevention of antibiotic-associated diarrhea involves taking the most targeted antibiotic for your infection and nourishing your gut with good bacteria through probiotics and foods like yogurt.
In this article:
Can antibiotics cause diarrhea?Â
Which antibiotics cause diarrhea?
Symptoms of antibiotic-associated diarrhea
What should I eat if I have diarrhea from antibiotics?
How to stop diarrhea from antibiotics
How to prevent diarrhea from antibiotics
In this article
Can antibiotics cause diarrhea?Â
Which antibiotics cause diarrhea?
Symptoms of antibiotic-associated diarrhea
What should I eat if I have diarrhea from antibiotics?
How to stop diarrhea from antibiotics
How to prevent diarrhea from antibiotics
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.Â
One of the most common complaints is antibiotic-induced diarrhea. Generally, diarrhea clears up after you stop taking the antibiotics. But while youâre on antibiotics, you may wonder how to stop yourself from running to the toilet and if you should tell your doctor whatâs happening. You may also wonder whether you can discontinue your antibiotics to resolve the problem.Â
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.
Itâs not unusual for antibiotics to cause loose stools, says
Jodie Pepin, Pharm.D
., the clinical pharmacy program director at Harbor Health.
Research
suggests that 5% to 35% of people taking antibiotics develop antibiotic-associated diarrhea.
Dr. Pepin says thereâs a reason these medicines can send you to the toilet:
Antibiotics
disrupt the natural balance of good and bad intestinal bacteria. When an antibiotic kills the good bacteria in your gut, your body canât process poop into its fully-formed, semi-soft consistency. However, the risk of diarrhea varies depending on the type of antibiotic.
âDifferent classes of antibiotics treat different types of bacteria,â says
Christina M. Madison, Pharm.D.
, FCCP, founder of The Public Health Pharmacist in Las Vegas.Â
âWhen we are unsure what the infection is being caused by, we typically use whatâs called âempiricâ therapy with a âbroad spectrumâ antibiotic,â she says. These broad-spectrum antibiotics kill good and bad bacteria, which might temporarily impede your bodyâs ability to make fully-formed stools. The result? Diarrhea.
According to the
Mayo Clinic
, antibiotic-induced diarrhea typically starts about a week after the first antibiotic dose.Â
Donât 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
Minesh Amin, DO
, medical director at Regenerate Medical Concierge in Henderson, Nevada.Â
Which antibiotics cause diarrhea?
Most antibiotics have the potential to cause diarrhea. However, Dr. Madison says âtargetedâ antibioticsâdrugs that are effective against just one bacterial typeâare 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 isnât necessarily what your provider considers before prescribing the antibiotic.
âWe can never select an antibiotic with the intent to try and avoid antibiotic-induced diarrhea,â says Dr. Amin. âThe choice of antibiotic is always based on the greatest likelihood of eradicating the active infection,â he explains.
Antibiotic drug classes associated with the most significant risk of antibiotic-induced diarrhea include:
Lincosamides
(like clindamycin) pose the highest risk of antibiotic-induced bacteria, according to a
meta-analysis
of more than 2 million reports of reactions to antibiotics.Â
Beta-lactams,
such as amoxicillin,
penicillin
,
ampicillin
, and
cephalosporins
(cephalexin, cefpodoxime, and cefdinir, for example)
Macrolides
,
such as
erythromycin
,
clarithromycin
, and
azithromycin
(though the latter has a slightly lower likelihood of disrupting gut bacteria, according to Dr. Madison)
Fluoroquinolones,
such as
ciprofloxacin
and
levofloxacin
, which Dr. Amin says are commonly prescribed for urinary tract infections and respiratory tract infections
Risk of C. difficile-associated diarrhea
In some cases, multiple courses of antibiotics can cause a bacteria called
Clostridioides difficile
(
C. diff
) to run rampant in the colon.Â
âWhen it is allowed to overgrow âŠ
C. diff
releases a toxin that damages the lining of our gut,â Dr. Pepin explains. âThe result of this is an infection that causes severe diarrhea and inflammation.â
Unlike other antibiotic-induced diarrhea,
C. diff
is highly contagious and dangerous, making it a concern among hospitalized patients. About
9% of adults 65 or older with a
C. difficile
infection
die within 30 days of diagnosis. Dr. Pepin says good hand-washing hygiene is essential to stopping the spread.Â
Symptoms of antibiotic-associated diarrhea
Most cases of
antibiotic-associated diarrhea
are mild, and symptoms include:
Loose, watery stools
Frequent bowel movements (three times per day or more)
Symptoms of
C. diff
infection are usually more severe. They include:
Loose, watery stools that are often uncontrollable
Frequent bowel movements
Abdominal pain
Gastrointestinal cramps
Nausea
Poor appetite
Fever
If you show signs of a
C. difficile
infection, consult a healthcare professional immediately.Â
What should I eat if I have diarrhea from antibiotics?
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.
âOne of the most common recommendations when experiencing antibiotic-induced diarrhea is the BRAT diet. This includes bananas, rice, applesauce, and toast,â he says. Dr. Amin also suggests eating yogurt for the following reasons:Â
It contains probiotics.
Yogurtâs probiotics can help offset the antibioticsâ eradication of good gut bacteria. Read the label to ensure you buy yogurt containing live active cultures.
It can soothe gut inflammation.
Plain yogurt can have a cooling effect on the gut, which might help settle your stomach after antibiotics.
It contains essential nutrients.
âYogurt is packed with essential nutrients such as calcium, B-12, and vitamin D,â Dr. Amin says.
Drink fluids with electrolytes.
Dehydration
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.
âElectrolyte 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,â Dr. Amin says.
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.
How to stop diarrhea from antibiotics
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
Cleveland Clinic
include:
Eat bland, low-fiber, starchy foods until the diarrhea resolves.
Avoid fried and spicy foods.
Avoid alcohol
and caffeine while taking antibiotics.
Take probiotics
to rebalance gut bacteria and stop the diarrhea.
Drink plenty of water, fruit juices, and electrolyte drinks to stay hydrated.
Consult your healthcare provider about anti-diarrheal medications such as loperamide (Imodium A-D) or possibly
Pepto-Bismol
.
Clinical trials
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.
âOne to two loose stools per day is common from antibiotic therapy,â Dr. Madison says. âIf you are experiencing significant side effects from your medication therapy, you should reach out to the prescribing provider before discontinuing therapy.â
Call your healthcare provider immediately if you experience additional symptoms such as weakness, fever, or loss of appetite. âA doctor can do a stool sample to test for
C. diff
and treat it quickly,â Dr. Pepin says.
How to prevent diarrhea from antibiotics
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.
Beyond that, prevention of antibiotic-associated diarrhea involves the same practices as treatment options:
Take the right drug for the right bug.
Dr.
Madison suggests taking the most targeted treatment for your infection versus a broad-spectrum antibiotic. This reduces the chance of disrupting your gut microbiome.
Add a probiotic
.
Dr. Amin says nourishing your gut with good bacteria can help prevent antibiotic-induced diarrhea and treat it when it occurs.
Keep protecting your digestive tract after the antibiotics are finished.
Stave off post-antibiotic diarrhea by eating yogurt with live active cultures or taking oral probiotic supplements for about a week after
completing your antibiotic course
, recommends Dr. Pepin. |
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# Can antibiotics cause diarrhea?
This common effect of the gut imbalance from antibiotics can be treated with home remedies

By [Leandra Beabout](https://www.singlecare.com/blog/author/leandra-beabout/ "Posts by Leandra Beabout") \| Sep. 15, 2023 Medically reviewed by [Jesse P. Houghton, MD, FACG](https://www.singlecare.com/blog/author/jesse-p-houghton)

## Key takeaways
- Antibiotics can cause diarrhea by disrupting the gutâs natural balance of good and bad bacteria. Broad-spectrum antibiotics pose a higher risk.
- Antibiotic-induced diarrhea typically starts about a week after beginning antibiotic treatment. If you experience diarrhea, consult your healthcare provider before stopping the medication.
- Eating bland, starchy foods, staying hydrated, and taking probiotics can help manage antibiotic-induced diarrhea. Itâs also important to avoid spicy, greasy foods and caffeine.
- Prevention of antibiotic-associated diarrhea involves taking the most targeted antibiotic for your infection and nourishing your gut with good bacteria through probiotics and foods like yogurt.
In this article:
- [Can antibiotics cause diarrhea?](https://www.singlecare.com/blog/diarrhea-from-antibiotics/#can-antibiotics-cause-diarrhea)
- [Which antibiotics cause diarrhea?](https://www.singlecare.com/blog/diarrhea-from-antibiotics/#which-antibiotics-cause-diarrhea)
- [Symptoms of antibiotic-associated diarrhea](https://www.singlecare.com/blog/diarrhea-from-antibiotics/#symptoms-of-antibiotic-associated-diarrhea)
- [What should I eat if I have diarrhea from antibiotics?](https://www.singlecare.com/blog/diarrhea-from-antibiotics/#what-should-i-eat-if-i-have-diarrhea-from-antibiotics)
- [How to stop diarrhea from antibiotics](https://www.singlecare.com/blog/diarrhea-from-antibiotics/#how-to-stop-diarrhea-from-antibiotics)
- [How to prevent diarrhea from antibiotics](https://www.singlecare.com/blog/diarrhea-from-antibiotics/#how-to-prevent-diarrhea-from-antibiotics)

In this article

- [Can antibiotics cause diarrhea?](https://www.singlecare.com/blog/diarrhea-from-antibiotics/#can-antibiotics-cause-diarrhea)
- [Which antibiotics cause diarrhea?](https://www.singlecare.com/blog/diarrhea-from-antibiotics/#which-antibiotics-cause-diarrhea)
- [Symptoms of antibiotic-associated diarrhea](https://www.singlecare.com/blog/diarrhea-from-antibiotics/#symptoms-of-antibiotic-associated-diarrhea)
- [What should I eat if I have diarrhea from antibiotics?](https://www.singlecare.com/blog/diarrhea-from-antibiotics/#what-should-i-eat-if-i-have-diarrhea-from-antibiotics)
- [How to stop diarrhea from antibiotics](https://www.singlecare.com/blog/diarrhea-from-antibiotics/#how-to-stop-diarrhea-from-antibiotics)
- [How to prevent diarrhea from antibiotics](https://www.singlecare.com/blog/diarrhea-from-antibiotics/#how-to-prevent-diarrhea-from-antibiotics)
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.
One of the most common complaints is antibiotic-induced diarrhea. Generally, diarrhea clears up after you stop taking the antibiotics. But while youâre on antibiotics, you may wonder how to stop yourself from running to the toilet and if you should tell your doctor whatâs happening. You may also wonder whether you can discontinue your antibiotics to resolve the problem.
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.
## Can antibiotics cause diarrhea?
Itâs not unusual for antibiotics to cause loose stools, says [Jodie Pepin, Pharm.D](https://www.harborhealth.com/clinicians/necessitatibus-magni-distinctio)., the clinical pharmacy program director at Harbor Health. [Research](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6067053) suggests that 5% to 35% of people taking antibiotics develop antibiotic-associated diarrhea.
Dr. Pepin says thereâs a reason these medicines can send you to the toilet: [Antibiotics](https://www.singlecare.com/blog/tag/antibiotics/) disrupt the natural balance of good and bad intestinal bacteria. When an antibiotic kills the good bacteria in your gut, your body canât process poop into its fully-formed, semi-soft consistency. However, the risk of diarrhea varies depending on the type of antibiotic.
âDifferent classes of antibiotics treat different types of bacteria,â says [Christina M. Madison, Pharm.D.](https://www.thepublichealthpharmacist.com/about), FCCP, founder of The Public Health Pharmacist in Las Vegas.
âWhen we are unsure what the infection is being caused by, we typically use whatâs called âempiricâ therapy with a âbroad spectrumâ antibiotic,â she says. These broad-spectrum antibiotics kill good and bad bacteria, which might temporarily impede your bodyâs ability to make fully-formed stools. The result? Diarrhea.
According to the [Mayo Clinic](https://www.mayoclinic.org/diseases-conditions/antibiotic-associated-diarrhea/symptoms-causes/syc-20352231), antibiotic-induced diarrhea typically starts about a week after the first antibiotic dose.
Donât 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 [Minesh Amin, DO](https://regeneratemedicalconcierge.com/about/), medical director at Regenerate Medical Concierge in Henderson, Nevada.
## Which antibiotics cause diarrhea?
Most antibiotics have the potential to cause diarrhea. However, Dr. Madison says âtargetedâ antibioticsâdrugs that are effective against just one bacterial typeâare 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 isnât necessarily what your provider considers before prescribing the antibiotic.
âWe can never select an antibiotic with the intent to try and avoid antibiotic-induced diarrhea,â says Dr. Amin. âThe choice of antibiotic is always based on the greatest likelihood of eradicating the active infection,â he explains.
Antibiotic drug classes associated with the most significant risk of antibiotic-induced diarrhea include:
- **Lincosamides** (like clindamycin) pose the highest risk of antibiotic-induced bacteria, according to a [meta-analysis](https://www.medsci.org/v16p0630.htm) of more than 2 million reports of reactions to antibiotics.
- **Beta-lactams,** such as amoxicillin, [penicillin](https://www.singlecare.com/drug-classes/penicillins), [ampicillin](https://www.singlecare.com/prescription/ampicillin), and [cephalosporins](https://www.singlecare.com/drug-classes/cephalosporins) (cephalexin, cefpodoxime, and cefdinir, for example)
- [**Macrolides**](https://doi.org/10.1002/14651858.CD011825.pub2)**,** such as [erythromycin](https://www.singlecare.com/prescription/erythromycin), [clarithromycin](https://www.singlecare.com/prescription/clarithromycin), and [azithromycin](https://www.singlecare.com/prescription/azithromycin) (though the latter has a slightly lower likelihood of disrupting gut bacteria, according to Dr. Madison)
- **Fluoroquinolones,** such as [ciprofloxacin](https://www.singlecare.com/prescription/ciprofloxacin) and [levofloxacin](https://www.singlecare.com/prescription/levofloxacin), which Dr. Amin says are commonly prescribed for urinary tract infections and respiratory tract infections
### Risk of C. difficile-associated diarrhea
In some cases, multiple courses of antibiotics can cause a bacteria called *Clostridioides difficile* ([C. diff](https://www.singlecare.com/conditions/clostridium-difficile-treatment-and-medications)) to run rampant in the colon.
âWhen it is allowed to overgrow ⊠*C. diff* releases a toxin that damages the lining of our gut,â Dr. Pepin explains. âThe result of this is an infection that causes severe diarrhea and inflammation.â
Unlike other antibiotic-induced diarrhea, [*C. diff*](https://www.singlecare.com/blog/antibiotics-that-cause-c-diff/) is highly contagious and dangerous, making it a concern among hospitalized patients. About [9% of adults 65 or older with a *C. difficile* infection](https://www.cdc.gov/media/releases/2015/p0225-clostridium-difficile.html) die within 30 days of diagnosis. Dr. Pepin says good hand-washing hygiene is essential to stopping the spread.
## Symptoms of antibiotic-associated diarrhea
Most cases of [antibiotic-associated diarrhea](https://www.mayoclinic.org/diseases-conditions/antibiotic-associated-diarrhea/symptoms-causes/syc-20352231) are mild, and symptoms include:
- Loose, watery stools
- Frequent bowel movements (three times per day or more)
Symptoms of *C. diff* infection are usually more severe. They include:
- Loose, watery stools that are often uncontrollable
- Frequent bowel movements
- Abdominal pain
- Gastrointestinal cramps
- Nausea
- Poor appetite
- [Fever](https://www.singlecare.com/blog/fever-temperature/)
If you show signs of a *C. difficile* infection, consult a healthcare professional immediately.
## What should I eat if I have diarrhea from antibiotics?
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.
âOne of the most common recommendations when experiencing antibiotic-induced diarrhea is the BRAT diet. This includes bananas, rice, applesauce, and toast,â he says. Dr. Amin also suggests eating yogurt for the following reasons:
- **It contains probiotics.** Yogurtâs probiotics can help offset the antibioticsâ eradication of good gut bacteria. Read the label to ensure you buy yogurt containing live active cultures.
- **It can soothe gut inflammation.** Plain yogurt can have a cooling effect on the gut, which might help settle your stomach after antibiotics.
- **It contains essential nutrients.** âYogurt is packed with essential nutrients such as calcium, B-12, and vitamin D,â Dr. Amin says.
Drink fluids with electrolytes. [Dehydration](https://www.niddk.nih.gov/health-information/digestive-diseases/diarrhea/symptoms-causes) 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.
âElectrolyte 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,â Dr. Amin says.
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.
## How to stop diarrhea from antibiotics
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 [Cleveland Clinic](https://health.clevelandclinic.org/how-to-prevent-diarrhea-while-you-take-antibiotics/) include:
- Eat bland, low-fiber, starchy foods until the diarrhea resolves.
- Avoid fried and spicy foods.
- [Avoid alcohol](https://www.singlecare.com/blog/alcohol-with-antibiotics/) and caffeine while taking antibiotics.
- [Take probiotics](https://www.singlecare.com/blog/taking-probiotics-with-antibiotics/) to rebalance gut bacteria and stop the diarrhea.
- Drink plenty of water, fruit juices, and electrolyte drinks to stay hydrated.
- Consult your healthcare provider about anti-diarrheal medications such as loperamide (Imodium A-D) or possibly Pepto-Bismol.
[Clinical trials](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3424311/) 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.
âOne to two loose stools per day is common from antibiotic therapy,â Dr. Madison says. âIf you are experiencing significant side effects from your medication therapy, you should reach out to the prescribing provider before discontinuing therapy.â
Call your healthcare provider immediately if you experience additional symptoms such as weakness, fever, or loss of appetite. âA doctor can do a stool sample to test for *C. diff* and treat it quickly,â Dr. Pepin says.
## How to prevent diarrhea from antibiotics
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.
Beyond that, prevention of antibiotic-associated diarrhea involves the same practices as treatment options:
- **Take the right drug for the right bug.** Dr. Madison suggests taking the most targeted treatment for your infection versus a broad-spectrum antibiotic. This reduces the chance of disrupting your gut microbiome.
- [**Add a probiotic**](https://www.singlecare.com/blog/probiotics-do-they-work/)**.** Dr. Amin says nourishing your gut with good bacteria can help prevent antibiotic-induced diarrhea and treat it when it occurs.
- **Keep protecting your digestive tract after the antibiotics are finished.** Stave off post-antibiotic diarrhea by eating yogurt with live active cultures or taking oral probiotic supplements for about a week after [completing your antibiotic course](https://www.singlecare.com/blog/finish-antibiotics/), recommends Dr. Pepin.
## Sources
- [Risk Factors for Antibiotic-Associated Diarrhea in Critically Ill Patients](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6067053/). Medical Science Monitor (2018)
- [Antibiotic-associated diarrhea](https://www.mayoclinic.org/diseases-conditions/antibiotic-associated-diarrhea/symptoms-causes/syc-20352231). Mayo Clinic (2021)
- [Adverse events in people taking macrolide antibiotics versus placebo for any indication.](https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD011825.pub2/full) Cochrane Library (2019)
- [Clostridium difficile Infection Risk with Important Antibiotic Classes: An Analysis of the FDA Adverse Event Reporting System](https://www.medsci.org/v16p0630.htm). International Journal of Medical Sciences (2019)
- [What is C.diff?](https://www.cdc.gov/cdiff/what-is.html) Centers for Disease Control and Prevention (2022)
- [Antibiotic-associated diarrhea](https://www.mayoclinic.org/diseases-conditions/antibiotic-associated-diarrhea/symptoms-causes/syc-20352231). Mayo Clinic (2021)
- [Symptoms & Causes of Diarrhea.](https://www.niddk.nih.gov/health-information/digestive-diseases/diarrhea/symptoms-causes) National Institute of Diabetes and Digestive and Kidney Diseases (2016)
- [How to Prevent Diarrhea While You Take Antibiotics](https://health.clevelandclinic.org/how-to-prevent-diarrhea-while-you-take-antibiotics/). Cleveland Clinic (2020)
- [A Gastroenterologistâs Guide to Probiotics.](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3424311/) Clinical Gastroenterology and Hepatology (2012)
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| Readable Markdown | ## Key takeaways
- Antibiotics can cause diarrhea by disrupting the gutâs natural balance of good and bad bacteria. Broad-spectrum antibiotics pose a higher risk.
- Antibiotic-induced diarrhea typically starts about a week after beginning antibiotic treatment. If you experience diarrhea, consult your healthcare provider before stopping the medication.
- Eating bland, starchy foods, staying hydrated, and taking probiotics can help manage antibiotic-induced diarrhea. Itâs also important to avoid spicy, greasy foods and caffeine.
- Prevention of antibiotic-associated diarrhea involves taking the most targeted antibiotic for your infection and nourishing your gut with good bacteria through probiotics and foods like yogurt.
In this article:
- [Can antibiotics cause diarrhea?](https://www.singlecare.com/blog/diarrhea-from-antibiotics/#can-antibiotics-cause-diarrhea)
- [Which antibiotics cause diarrhea?](https://www.singlecare.com/blog/diarrhea-from-antibiotics/#which-antibiotics-cause-diarrhea)
- [Symptoms of antibiotic-associated diarrhea](https://www.singlecare.com/blog/diarrhea-from-antibiotics/#symptoms-of-antibiotic-associated-diarrhea)
- [What should I eat if I have diarrhea from antibiotics?](https://www.singlecare.com/blog/diarrhea-from-antibiotics/#what-should-i-eat-if-i-have-diarrhea-from-antibiotics)
- [How to stop diarrhea from antibiotics](https://www.singlecare.com/blog/diarrhea-from-antibiotics/#how-to-stop-diarrhea-from-antibiotics)
- [How to prevent diarrhea from antibiotics](https://www.singlecare.com/blog/diarrhea-from-antibiotics/#how-to-prevent-diarrhea-from-antibiotics)
 In this article 
- [Can antibiotics cause diarrhea?](https://www.singlecare.com/blog/diarrhea-from-antibiotics/#can-antibiotics-cause-diarrhea)
- [Which antibiotics cause diarrhea?](https://www.singlecare.com/blog/diarrhea-from-antibiotics/#which-antibiotics-cause-diarrhea)
- [Symptoms of antibiotic-associated diarrhea](https://www.singlecare.com/blog/diarrhea-from-antibiotics/#symptoms-of-antibiotic-associated-diarrhea)
- [What should I eat if I have diarrhea from antibiotics?](https://www.singlecare.com/blog/diarrhea-from-antibiotics/#what-should-i-eat-if-i-have-diarrhea-from-antibiotics)
- [How to stop diarrhea from antibiotics](https://www.singlecare.com/blog/diarrhea-from-antibiotics/#how-to-stop-diarrhea-from-antibiotics)
- [How to prevent diarrhea from antibiotics](https://www.singlecare.com/blog/diarrhea-from-antibiotics/#how-to-prevent-diarrhea-from-antibiotics)
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.
One of the most common complaints is antibiotic-induced diarrhea. Generally, diarrhea clears up after you stop taking the antibiotics. But while youâre on antibiotics, you may wonder how to stop yourself from running to the toilet and if you should tell your doctor whatâs happening. You may also wonder whether you can discontinue your antibiotics to resolve the problem.
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.
Itâs not unusual for antibiotics to cause loose stools, says [Jodie Pepin, Pharm.D](https://www.harborhealth.com/clinicians/necessitatibus-magni-distinctio)., the clinical pharmacy program director at Harbor Health. [Research](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6067053) suggests that 5% to 35% of people taking antibiotics develop antibiotic-associated diarrhea.
Dr. Pepin says thereâs a reason these medicines can send you to the toilet: [Antibiotics](https://www.singlecare.com/blog/tag/antibiotics/) disrupt the natural balance of good and bad intestinal bacteria. When an antibiotic kills the good bacteria in your gut, your body canât process poop into its fully-formed, semi-soft consistency. However, the risk of diarrhea varies depending on the type of antibiotic.
âDifferent classes of antibiotics treat different types of bacteria,â says [Christina M. Madison, Pharm.D.](https://www.thepublichealthpharmacist.com/about), FCCP, founder of The Public Health Pharmacist in Las Vegas.
âWhen we are unsure what the infection is being caused by, we typically use whatâs called âempiricâ therapy with a âbroad spectrumâ antibiotic,â she says. These broad-spectrum antibiotics kill good and bad bacteria, which might temporarily impede your bodyâs ability to make fully-formed stools. The result? Diarrhea.
According to the [Mayo Clinic](https://www.mayoclinic.org/diseases-conditions/antibiotic-associated-diarrhea/symptoms-causes/syc-20352231), antibiotic-induced diarrhea typically starts about a week after the first antibiotic dose.
Donât 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 [Minesh Amin, DO](https://regeneratemedicalconcierge.com/about/), medical director at Regenerate Medical Concierge in Henderson, Nevada.
## Which antibiotics cause diarrhea?
Most antibiotics have the potential to cause diarrhea. However, Dr. Madison says âtargetedâ antibioticsâdrugs that are effective against just one bacterial typeâare 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 isnât necessarily what your provider considers before prescribing the antibiotic.
âWe can never select an antibiotic with the intent to try and avoid antibiotic-induced diarrhea,â says Dr. Amin. âThe choice of antibiotic is always based on the greatest likelihood of eradicating the active infection,â he explains.
Antibiotic drug classes associated with the most significant risk of antibiotic-induced diarrhea include:
- **Lincosamides** (like clindamycin) pose the highest risk of antibiotic-induced bacteria, according to a [meta-analysis](https://www.medsci.org/v16p0630.htm) of more than 2 million reports of reactions to antibiotics.
- **Beta-lactams,** such as amoxicillin, [penicillin](https://www.singlecare.com/drug-classes/penicillins), [ampicillin](https://www.singlecare.com/prescription/ampicillin), and [cephalosporins](https://www.singlecare.com/drug-classes/cephalosporins) (cephalexin, cefpodoxime, and cefdinir, for example)
- [**Macrolides**](https://doi.org/10.1002/14651858.CD011825.pub2)**,** such as [erythromycin](https://www.singlecare.com/prescription/erythromycin), [clarithromycin](https://www.singlecare.com/prescription/clarithromycin), and [azithromycin](https://www.singlecare.com/prescription/azithromycin) (though the latter has a slightly lower likelihood of disrupting gut bacteria, according to Dr. Madison)
- **Fluoroquinolones,** such as [ciprofloxacin](https://www.singlecare.com/prescription/ciprofloxacin) and [levofloxacin](https://www.singlecare.com/prescription/levofloxacin), which Dr. Amin says are commonly prescribed for urinary tract infections and respiratory tract infections
### Risk of C. difficile-associated diarrhea
In some cases, multiple courses of antibiotics can cause a bacteria called *Clostridioides difficile* ([C. diff](https://www.singlecare.com/conditions/clostridium-difficile-treatment-and-medications)) to run rampant in the colon.
âWhen it is allowed to overgrow ⊠*C. diff* releases a toxin that damages the lining of our gut,â Dr. Pepin explains. âThe result of this is an infection that causes severe diarrhea and inflammation.â
Unlike other antibiotic-induced diarrhea, [*C. diff*](https://www.singlecare.com/blog/antibiotics-that-cause-c-diff/) is highly contagious and dangerous, making it a concern among hospitalized patients. About [9% of adults 65 or older with a *C. difficile* infection](https://www.cdc.gov/media/releases/2015/p0225-clostridium-difficile.html) die within 30 days of diagnosis. Dr. Pepin says good hand-washing hygiene is essential to stopping the spread.
## Symptoms of antibiotic-associated diarrhea
Most cases of [antibiotic-associated diarrhea](https://www.mayoclinic.org/diseases-conditions/antibiotic-associated-diarrhea/symptoms-causes/syc-20352231) are mild, and symptoms include:
- Loose, watery stools
- Frequent bowel movements (three times per day or more)
Symptoms of *C. diff* infection are usually more severe. They include:
- Loose, watery stools that are often uncontrollable
- Frequent bowel movements
- Abdominal pain
- Gastrointestinal cramps
- Nausea
- Poor appetite
- [Fever](https://www.singlecare.com/blog/fever-temperature/)
If you show signs of a *C. difficile* infection, consult a healthcare professional immediately.
## What should I eat if I have diarrhea from antibiotics?
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.
âOne of the most common recommendations when experiencing antibiotic-induced diarrhea is the BRAT diet. This includes bananas, rice, applesauce, and toast,â he says. Dr. Amin also suggests eating yogurt for the following reasons:
- **It contains probiotics.** Yogurtâs probiotics can help offset the antibioticsâ eradication of good gut bacteria. Read the label to ensure you buy yogurt containing live active cultures.
- **It can soothe gut inflammation.** Plain yogurt can have a cooling effect on the gut, which might help settle your stomach after antibiotics.
- **It contains essential nutrients.** âYogurt is packed with essential nutrients such as calcium, B-12, and vitamin D,â Dr. Amin says.
Drink fluids with electrolytes. [Dehydration](https://www.niddk.nih.gov/health-information/digestive-diseases/diarrhea/symptoms-causes) 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.
âElectrolyte 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,â Dr. Amin says.
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.
## How to stop diarrhea from antibiotics
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 [Cleveland Clinic](https://health.clevelandclinic.org/how-to-prevent-diarrhea-while-you-take-antibiotics/) include:
- Eat bland, low-fiber, starchy foods until the diarrhea resolves.
- Avoid fried and spicy foods.
- [Avoid alcohol](https://www.singlecare.com/blog/alcohol-with-antibiotics/) and caffeine while taking antibiotics.
- [Take probiotics](https://www.singlecare.com/blog/taking-probiotics-with-antibiotics/) to rebalance gut bacteria and stop the diarrhea.
- Drink plenty of water, fruit juices, and electrolyte drinks to stay hydrated.
- Consult your healthcare provider about anti-diarrheal medications such as loperamide (Imodium A-D) or possibly Pepto-Bismol.
[Clinical trials](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3424311/) 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.
âOne to two loose stools per day is common from antibiotic therapy,â Dr. Madison says. âIf you are experiencing significant side effects from your medication therapy, you should reach out to the prescribing provider before discontinuing therapy.â
Call your healthcare provider immediately if you experience additional symptoms such as weakness, fever, or loss of appetite. âA doctor can do a stool sample to test for *C. diff* and treat it quickly,â Dr. Pepin says.
## How to prevent diarrhea from antibiotics
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.
Beyond that, prevention of antibiotic-associated diarrhea involves the same practices as treatment options:
- **Take the right drug for the right bug.** Dr. Madison suggests taking the most targeted treatment for your infection versus a broad-spectrum antibiotic. This reduces the chance of disrupting your gut microbiome.
- [**Add a probiotic**](https://www.singlecare.com/blog/probiotics-do-they-work/)**.** Dr. Amin says nourishing your gut with good bacteria can help prevent antibiotic-induced diarrhea and treat it when it occurs.
- **Keep protecting your digestive tract after the antibiotics are finished.** Stave off post-antibiotic diarrhea by eating yogurt with live active cultures or taking oral probiotic supplements for about a week after [completing your antibiotic course](https://www.singlecare.com/blog/finish-antibiotics/), recommends Dr. Pepin. |
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