Gastroenterology

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Pulmonology Pediatrics Otorhinolaryngology Gastroenterology

Commonly hailed as one of the most important advances of the 20th century, antibiotics have saved millions of lives.

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Created 25 August 2021
Updated 07 January 2022

They also had, however, a deleterious impact on microbiota:

  • antibiotic-induced dysbiosis, which is associated with both short- and long-term health consequences;
  • host-specific pool of antimicrobial resistance genes and organisms developing as a result of the misuse or overuse of antibiotics.


This points to the need for antibiotics to be handled with care, and that a more rational use of antibiotics be adopted.

Antibiotic-induced dysbiosis can affect every human microbiota:

  • Gut microbiota:
    Diarrhea, its main short-term side effect, occurs in up to 35% of patients receiving antibiotics;1,2,3

  • Urogenital microbiota:
    Following antibiotic treatment, between 10 and 30% of women go on to develop vulvovaginal candidiasis;4

  • Cutaneous microbiota:
    60% of patients treated for acne have macrolid-resistant Cutibacterium acnes strains;

  • Ears-nos-throat microbiota:
    Antibiotics administered for upper respiratory tract infections increase by a factor of 2.6 the incidence of acute otitis media;

  • Lung microbiota:
    Broad-spectrum antibiotics used for treating lung infections are regarded as one of the principal contributors to the overall burden of antibiotic resistance.

What to do?

To prevent dysbiosis:

  • adopting a more diverse diet, high in fiber: diet has a considerable influence on the composition of the intestinal microbiota;5
  • using probiotics6: when administered in adequate amounts these live microorganisms (yeasts or bacteria) confer a definite health benefit on the host;7
  • using prebiotics: substrates that are selectively utilized by host microorganisms and which thereby confer health benefits.8

To promote the reconstruction and the functionality of a dysbiotic microbiota:

  • using probiotics (yeasts or bacteria) may be helpful;6
  • considering fecal microbiota transplantation to treat recurrent Clostridioides difficile infection only.9

To combat antimicrobial resistance:

  • explore phage therapy:10 phages, the natural predators of bacteria, were used to treat bacterial infections before the advent of antibiotics;
  • investigate CRISPR-Cas9:11: these “molecular scissors” could be used to implement corrections to genes;
  • consider nanomaterial-based therapies:12: the physical properties of certain nanomaterials endow them with the capability to target biofilms.
Sources

1 McFarland LV, Ozen M, Dinleyici EC et al. Comparison of pediatric and adult antibiotic-associated diarrhea and Clostridium difficile infections. World J Gastroenterol. 2016;22(11):3078-3104.

2 Bartlett JG. Clinical practice. Antibiotic-associated diarrhea. N Engl J Med 2002;346:334-9.

3 Theriot CM, Young VB. Interactions Between the Gastrointestinal Microbiome and Clostridium difficile. Annu Rev Microbiol. 2015;69:445-461.

4 Shukla A, Sobel JD. Vulvovaginitis Caused by Candida Species Following Antibiotic Exposure. Curr Infect Dis Rep. 2019 Nov 9;21(11):44.

5 Levy M, Kolodziejczyk AA, Thaiss CA et al. Dysbiosis and the immune system. Nat Rev Immunol. 2017;17(4):219-232.

6 Guarner F, Sanders ME, Eliakim R, et al. World Gastroenterology Organisation Global Guidelines. Probiotics and Prebiotics. 2017

7 FAO. Probiotics in Food: Health and Nutritional Properties and Guidelines for Evaluation (Food and Agriculture Organization of the United Nations, Rome, 2006)

8 https://isappscience.org/for-scientists/resources/prebiotics/

9 Cammarota G, Ianiro G, Tilg H, et al. European consensus conference on faecal microbiota transplantation in clinical practice. Gut 2017 ; 66 : 569-80.

10 Langdon A, Crook N, Dantas G. The effects of antibiotics on the microbiome throughout development and alternative approaches for therapeutic modulation. Genome Med. 2016;8(1):39.

11 Gholizadeh P, Köse Ş, Dao S, et al., How CRISPR-Cas System Could Be Used to Combat Antimicrobial Resistance. Infect Drug Resist. 2020 Apr 20;13:1111-1121.

12 Makabenta JMV, Nabawy A, Li CH et al. Nanomaterial-based therapeutics for antibiotic-resistant bacterial infections. Nat Rev Microbiol. 2020 Aug 19.

 

 

Tags
Otitis Probiotics AAD Microbiome Flora

    See also

    Focus

    The Janus face of Antibiotics: Life Savers & Microbiota Disrupters

    Introduction

    The Janus face of Antibiotics: Life Savers and Microbiota Disruptors

    Gut

    From diarrhea to chronic diseases: the well-documented consequences of antibiotic-related gut microbiota dysbiosis

    Urogenital

    Urogenital microbiota: the spectrum of mycosis or urinary tract infections after each antibiotic treatment

    Cutaneous

    Antibiotics, a double-edged sword when managing skin disease

    ENT

    Ears, Nose and Throat microbiota: when antibiotics challenge our first line of defense

    Lung

    Antibiotic resistance: the lung microbiota pays a heavy price

    Conclusion

    What to take away?

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