About half of Americans have used at least one prescription drug at some point in the past thirty days, according to data from the Centers for Disease Control and Prevention. For many people, those drugs are a crucial tool to maintain their health. But what kind of toll are those medications taking? As scientists learn more about the gut microbiome, they're also learning more about how drugs affect the organisms that make up the microbiome, like bacteria, fungi, and archaea. Common sense would tell us that antibiotics can drastically alter the microbiome; they eliminate bacteria that live there indiscriminately. But, according to new research, other medications that are used to treat health issues like obesity, diabetes, and coronary artery disease can also affect the microbiome. These findings have been reported in Nature.
In this study, the a team of researchers assessed the impact of 28 drugs and some drug combinations on the microbiome, and found that the influence of medications is complex. "Many drugs negatively impact the composition and state of the gut bacteria, but others, including aspirin, can have a positive influence on the gut microbiome. We found that drugs can have a more pronounced effect on the host microbiome than disease, diet, and smoking combined," said corresponding study author Peer Bork, the Director of Scientific Activities at EMBL Heidelberg.
Although antibiotics clearly disrupt the gut microbiome, repeated exposure to antibiotics over time seems to have a cumulative effect.
"We found that the gut microbiome of patients taking multiple courses of antibiotics over five years became less healthy. That included signs indicating antimicrobial resistance," said co-first study author Sofia Forslund, PhD, who is now a group leader at the Max Delbrück Center for Molecular Medicine.
For this work, the researchers were able to assess data from over 2,000 cardiometabolic disease patients, many of whom take more than one drug regularly. This amount of data also revealed that the drug dosage also influences how a drug affects the microbiome, said co-first study author Maria Zimmermann-Kogadeeva, a group leader at EMBL Heidelberg.
The researchers are hopeful that the study could help clinicians make better choices when creating plans for treating or preventing disease.
Sources: European Molecular Biology Laboratory (EMBL), Nature
