Microbiotoxicity: antibiotic usage and its unintended harm to the microbiome.
Microbiotoxicity: antibiotic usage and its unintended harm to the microbiome.
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微生物毒性：抗生素使用及其对微生物组的意外伤害。
DOI：
10.1097/qco.0000000000000945
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发表时间：
2023-10-01
影响因子：
3.9
通讯作者：
中科院分区：
文献类型：
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作者：
抗生素的使用与抗菌素耐药性的产生和微生物群(整个宿主微生物群落)的失调有关。这些变化反过来又与下游不利的健康后果有关。这篇综述分析了一个快速发展的领域中最近的重要出版物，结合现有的证据来帮助临床医生权衡抗生素对患者微生物组的潜在风险。虽然大多数微生物组研究是观察性的，但我们强调最近的干预性研究，探索抗生素使用、微生物组破坏和健康不良之间的联系。这些研究包括无菌小鼠模型，对健康人类志愿者的抗生素挑战，以及世界上第一个被批准的基于微生物组的药物的第三阶段研究。抗生素介导的微生物群扰动的相关临床和实验证据越来越多令人担忧，尽管还需要进一步的因果证据。在这些证据的限制下，我们提出了一个新的术语‘微生物毒性’来描述抗生素对患者微生物群的意外伤害。我们建议一个框架，让处方医生权衡微生物毒性效应与抗生素使用的预期好处。
Antibiotic use is associated with development of antimicrobial resistance and dysregulation of the microbiome (the overall host microbial community). These changes have in turn been associated with downstream adverse health outcomes. This review analyses recent important publications in a rapidly evolving field, contextualizing the available evidence to assist clinicians weighing the potential risks of antibiotics on a patient's microbiome. Although the majority of microbiome research is observational, we highlight recent interventional studies probing the associations between antibiotic use, microbiome disruption, and ill-health. These studies include germ-free mouse models, antibiotic challenge in healthy human volunteers, and a phase III study of the world's first approved microbiome-based medicine. The growing body of relevant clinical and experimental evidence for antibiotic-mediated microbiome perturbation is concerning, although further causal evidence is required. Within the limits of this evidence, we propose the novel term ‘microbiotoxicity’ to describe the unintended harms of antibiotics on a patient's microbiome. We suggest a framework for prescribers to weigh microbiotoxic effects against the intended benefits of antibiotic use.