The impact of mass drug administration of antibiotics on the gut microbiota of target populations

Abstract

Antibiotics have become a mainstay of healthcare in the past century due to their activity against pathogens. This manuscript reviews the impact of antibiotic use on the intestinal microbiota in the context of mass drug administration (MDA). The importance of the gut microbiota to human metabolism and physiology is now well established, and antibiotic exposure may impact host health via collateral effects on the microbiota and its functions. To gain further insight into how gut microbiota respond to antibiotic perturbation and the implications for public health, factors that influence the impact of antibiotic exposure on the microbiota, potential health outcomes of antibiotic-induced microbiota alterations, and strategies that have the potential to ameliorate these wider antibiotic-associated microbiota perturbations are also reviewed. Graphical Abstract

Assessment of the impact of intravenous antibiotics treatment on gut microbiota in patients: Clinical data from pre-and post-cardiac surgery

“…The surface and inside of humans are covered by a multitude of microorganisms. The gastrointestinal tract is the site of the majority of microbial biomass and biodiversity in the human body (Bibbo et al, 2016;Jourova et al, 2016;Gough, 2022). Recently, gut microbiota was found to play a critical role in many physiological and pathological processes in the human body.…”

“…The physiology of almost all organisms' organs is influenced by gut microbiota. In particular, gut microbiota could influence the biotransformation of xenobiotics (Lozupone et al, 2012;Jourova et al, 2016;Gough, 2022). However, the use of antibiotics could disturb the composition and functioning of the gut microbiota (Becattini et al, 2016;Jourova et al, 2016;Mangiola et al, 2018;Hao et al, 2020;Gough, 2022).…”

“…In particular, gut microbiota could influence the biotransformation of xenobiotics (Lozupone et al, 2012;Jourova et al, 2016;Gough, 2022). However, the use of antibiotics could disturb the composition and functioning of the gut microbiota (Becattini et al, 2016;Jourova et al, 2016;Mangiola et al, 2018;Hao et al, 2020;Gough, 2022). Some studies evaluated the impact of antibiotics on the gut microbiota in pediatric patients.…”

“…Some studies evaluated the impact of antibiotics on the gut microbiota in pediatric patients. Oral antibiotics were the major intervention for part of these studies (Gough, 2022). Although some intravenous antibiotics also were evaluated, a single antibiotic was the intervention in most studies (Gough, 2022).…”

Implementation of mass drug administration of antibiotics in low- and middle- income countries

“…The contribution that MDA programmes might make to the worsening of AMR is not known. Evidence exists that suggests azithromycin MDA may lead to a degree of macrolide and nonmacrolide resistance, however the clinical and public health relevant of such resistance is currently unknown and clearly warrants further research 39,40,70 . Despite this, the guidelines discussed above appear to downplay the risk of worsening AMR 6-10 .…”