The Impact of Antibiotic Therapy on Intestinal Microbiota: Dysbiosis, Antibiotic Resistance, and Restoration Strategies
The human gut microbiota—an intricate and dynamic ecosystem—plays a pivotal role in metabolic regulation, immune modulation, and the maintenance of intestinal barrier integrity. Although antibiotic therapy is indispensable for managing bacterial infections, it profoundly disrupts gut microbial commu...
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MDPI AG
2025-04-01
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| author | Gaia Cusumano Giancarlo Angeles Flores Roberto Venanzoni Paola Angelini |
| author_facet | Gaia Cusumano Giancarlo Angeles Flores Roberto Venanzoni Paola Angelini |
| author_sort | Gaia Cusumano |
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| description | The human gut microbiota—an intricate and dynamic ecosystem—plays a pivotal role in metabolic regulation, immune modulation, and the maintenance of intestinal barrier integrity. Although antibiotic therapy is indispensable for managing bacterial infections, it profoundly disrupts gut microbial communities. Such dysbiosis is typified by diminished diversity and shifts in community structure, especially among beneficial bacterial genera (e.g., <i>Bifidobacterium</i> and <i>Eubacterium</i>), and fosters antibiotic-resistant strains and the horizontal transfer of resistance genes. These alterations compromise colonization resistance, increase intestinal permeability, and amplify susceptibility to opportunistic pathogens like <i>Clostridioides difficile</i>. Beyond gastrointestinal disorders, emerging evidence associates dysbiosis with systemic conditions, including chronic inflammation, metabolic syndrome, and neurodegenerative diseases, underscoring the relevance of the microbiota–gut–brain axis. The recovery of pre-existing gut communities post-antibiotic therapy is highly variable, influenced by drug spectrum, dosage, and treatment duration. Innovative interventions—such as fecal microbiota transplantation (FMT), probiotics, synbiotics, and precision microbiome therapeutics—have shown promise in counteracting dysbiosis and mitigating its adverse effects. These therapies align closely with antibiotic stewardship programs aimed at minimizing unnecessary antibiotic use to preserve microbial diversity and curtail the spread of multidrug-resistant organisms. This review emphasizes the pressing need for microbiota-centered strategies to optimize antibiotic administration, promote long-term health resilience, and alleviate the disease burden associated with antibiotic-induced dysbiosis. |
| format | Article |
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| institution | OA Journals |
| issn | 2079-6382 |
| language | English |
| publishDate | 2025-04-01 |
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| spelling | doaj-art-eac991600a3f4f54878fc224bf0f5cd22025-08-20T02:17:25ZengMDPI AGAntibiotics2079-63822025-04-0114437110.3390/antibiotics14040371The Impact of Antibiotic Therapy on Intestinal Microbiota: Dysbiosis, Antibiotic Resistance, and Restoration StrategiesGaia Cusumano0Giancarlo Angeles Flores1Roberto Venanzoni2Paola Angelini3Department of Chemistry, Biology and Biotechnology, University of Perugia, Via del Giochetto, 06122 Perugia, ItalyDepartment of Chemistry, Biology and Biotechnology, University of Perugia, Via del Giochetto, 06122 Perugia, ItalyDepartment of Chemistry, Biology and Biotechnology, University of Perugia, Via del Giochetto, 06122 Perugia, ItalyDepartment of Chemistry, Biology and Biotechnology, University of Perugia, Via del Giochetto, 06122 Perugia, ItalyThe human gut microbiota—an intricate and dynamic ecosystem—plays a pivotal role in metabolic regulation, immune modulation, and the maintenance of intestinal barrier integrity. Although antibiotic therapy is indispensable for managing bacterial infections, it profoundly disrupts gut microbial communities. Such dysbiosis is typified by diminished diversity and shifts in community structure, especially among beneficial bacterial genera (e.g., <i>Bifidobacterium</i> and <i>Eubacterium</i>), and fosters antibiotic-resistant strains and the horizontal transfer of resistance genes. These alterations compromise colonization resistance, increase intestinal permeability, and amplify susceptibility to opportunistic pathogens like <i>Clostridioides difficile</i>. Beyond gastrointestinal disorders, emerging evidence associates dysbiosis with systemic conditions, including chronic inflammation, metabolic syndrome, and neurodegenerative diseases, underscoring the relevance of the microbiota–gut–brain axis. The recovery of pre-existing gut communities post-antibiotic therapy is highly variable, influenced by drug spectrum, dosage, and treatment duration. Innovative interventions—such as fecal microbiota transplantation (FMT), probiotics, synbiotics, and precision microbiome therapeutics—have shown promise in counteracting dysbiosis and mitigating its adverse effects. These therapies align closely with antibiotic stewardship programs aimed at minimizing unnecessary antibiotic use to preserve microbial diversity and curtail the spread of multidrug-resistant organisms. This review emphasizes the pressing need for microbiota-centered strategies to optimize antibiotic administration, promote long-term health resilience, and alleviate the disease burden associated with antibiotic-induced dysbiosis.https://www.mdpi.com/2079-6382/14/4/371antibiotic resistancedysbiosisfecal microbiota transplantationgut microbiotamicrobial diversityprobiotics |
| spellingShingle | Gaia Cusumano Giancarlo Angeles Flores Roberto Venanzoni Paola Angelini The Impact of Antibiotic Therapy on Intestinal Microbiota: Dysbiosis, Antibiotic Resistance, and Restoration Strategies Antibiotics antibiotic resistance dysbiosis fecal microbiota transplantation gut microbiota microbial diversity probiotics |
| title | The Impact of Antibiotic Therapy on Intestinal Microbiota: Dysbiosis, Antibiotic Resistance, and Restoration Strategies |
| title_full | The Impact of Antibiotic Therapy on Intestinal Microbiota: Dysbiosis, Antibiotic Resistance, and Restoration Strategies |
| title_fullStr | The Impact of Antibiotic Therapy on Intestinal Microbiota: Dysbiosis, Antibiotic Resistance, and Restoration Strategies |
| title_full_unstemmed | The Impact of Antibiotic Therapy on Intestinal Microbiota: Dysbiosis, Antibiotic Resistance, and Restoration Strategies |
| title_short | The Impact of Antibiotic Therapy on Intestinal Microbiota: Dysbiosis, Antibiotic Resistance, and Restoration Strategies |
| title_sort | impact of antibiotic therapy on intestinal microbiota dysbiosis antibiotic resistance and restoration strategies |
| topic | antibiotic resistance dysbiosis fecal microbiota transplantation gut microbiota microbial diversity probiotics |
| url | https://www.mdpi.com/2079-6382/14/4/371 |
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