NutriStack
Probiotics and Trimethoprim-Sulfamethoxazole, a synergy.
Probiotic supplementation during trimethoprim-sulfamethoxazole therapy reduces antibiotic-associated diarrhea and helps preserve gut microbiome diversity disrupted by broad-spectrum coverage.
One pair, every claim cited. The two substances, the type, the mechanism, the recommendation, and the primary literature.
Same shape as the other 1,729 pairs in the public database.
From the interaction database
What the row says.
Every entry follows the same shape: what is happening, the mechanism, the recommendation, and the primary literature.
At a glance
- Substances
- Probiotics and Trimethoprim-Sulfamethoxazole
- Pair type
- Synergy
- Evidence (highest tier)
- Strong
- Source citations
- 2 sources
- Stack Score effect
- +2 to your Stack Score (per scored synergy row).
- Scope
- Supplement × Prescription
- Last verified
- May 30, 2026
Synergy · Strong evidence
Synergy
What is happening. Probiotic supplementation during trimethoprim-sulfamethoxazole therapy reduces antibiotic-associated diarrhea and helps preserve gut microbiome diversity disrupted by broad-spectrum coverage.
Mechanism. Probiotics restore colonization resistance disrupted by broad-spectrum antibiotics, competing with opportunistic pathogens such as Clostridioides difficile for nutrients and binding sites.
Recommendation. Take probiotics throughout your TMP-SMX course, separated by at least 2 hours from each antibiotic dose. Continue for at least 1 week after the antibiotic ends.
Minimum separation. 120
Sources (2)
- Doar NW, Samuthiram SD. Qualitative Analysis of the Efficacy of Probiotic Strains in the Prevention of Antibiotic-Associated Diarrhea. Cureus. 2023;15(6):e40261. PMID 37440799
- McFarland LV. Probiotics for the Primary and Secondary Prevention of C. difficile Infections: A Meta-analysis and Systematic Review. Antibiotics (Basel). 2015;4(2):160-78. PMID 27025619
Stack Score
How this pair moves the number.
Effect on the composite score
If both Probiotics and Trimethoprim-Sulfamethoxazole are in the same stack, this pair applies +2 to your Stack Score (per scored synergy row).
The full algorithm, the clamping rules, and four worked stacks are documented at /methodology/stack-score.
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