Antibiotic use linked to persistent gut microbiome changes up to 8 years

 Hopefully your competent? doctor has EXACT PROTOCOLS  to measure and correct your gut microbiome! You do want better stroke recovery, right?

• gut microbiome (59 posts to March 2016)

Antibiotic use linked to persistent gut microbiome changes up to 8 years

Certain oral antibiotics may have long-lasting effects on gut microbiome composition, with measurable reductions in microbial diversity persisting for up to 8 years after exposure, according to a large population-based study published in Nature Medicine.

The study analysed 14,979 adults by linking prescription data from the Swedish Prescribed Drug Register with faecal metagenomic sequencing. Using multivariable, confounder-adjusted regression models, investigators assessed associations between antibiotic use over an 8-year period and gut microbiome diversity and species abundance at the time of sampling.

Antibiotic exposure within 1 year prior to sampling was associated with the greatest reduction in species diversity; however, significant associations were also observed for use 1-4 years and 4-8 years earlier. 

Clindamycin, fluoroquinolones, and flucloxacillin showed the largest effects on microbial diversity. Each course of clindamycin within 1 year before faecal sampling was associated with an average of 47 fewer species detected (q-value = 2.1 x 10⁻¹⁷), while fluoroquinolones and flucloxacillin were associated with reductions of approximately 20 and 21 species, respectively (q-values = 1.3 x 10⁻⁶ and 1.4 x 10⁻⁶). 

Notably, use of fluoroquinolones, flucloxacillin, and tetracyclines 1-4 years and 4-8 years before sampling remained associated with reduced diversity, whereas clindamycin and macrolides were associated with lower diversity up to 4 years but not beyond.

In an analysis restricted to participants receiving 1 antibiotic course or none, a single course of 7 of 11 antibiotics was associated with reduced gut microbiome diversity 4 to 8 years post-treatment.

In contrast, several commonly used antibiotics were not associated with changes in gut diversity, including extended-spectrum penicillins, amoxicillin-clavulanic acid, and sulfamethoxazole-trimethoprim.

Analysis of gut bacterial abundance following antibiotic use revealed that clindamycin, flucloxacillin, and fluoroquinolones had the most pronounced effects. Use of clindamycin 1 year before sampling was associated with changes in 296 of 1,340 species analysed, whilst flucloxacillin was associated with changes in 203 species and fluoroquinolones with 172 species. Use of these antibiotics 4-8 years before sampling was associated with altered abundance in 10% to 15% of gut microbiome species studied, whilst penicillin V, extended-spectrum penicillins, and nitrofurantoin were associated with altered abundance of only a few species.

“These findings support the notion that the effect of antibiotics on the gut microbiome may persist for several years,” concluded Gabriel Baldanzi, Uppsala University, Uppsala, Sweden, and colleagues. “Our results may inform future guidelines on outpatient antimicrobial stewardship interventions and practices, which should, when possible, prioritise antibiotics that have a lower impact on the gut microbiome.”

Source: Nature Medicine