In a new study, researchers found that 18 commonly used drug categories extensively affect the structure and metabolic function of the gut microbiome.
Eight categories of drugs were also found to increase antimicrobial resistance mechanisms in the study participants.
The research was conducted by a team at the University Medical Center Groningen and the Maastricht University Medical Center
Gut microbiota is the microbe population living in the intestine. It contains tens of trillions of microorganisms, including at least 1000 different species of known bacteria.
The human gut microbiota population is influenced by a number of different factors, including medication.
The microbiome has received increasing attention over the last 15 years with numerous studies reporting changes in gut microbiota during not only obesity, diabetes, and liver diseases but also cancer and neurodegenerative diseases.
In the study, the team looked at 41 commonly used drug categories and assessed 1,883 fecal samples from a population-based cohort, patients with IBD and patients with IBS intermixed with healthy controls.
The researchers compared the metabolic functions profiles of drug users to non-drug users, looking at the effect of single medication use and then combined medication use.
The changes observed could increase the risk of intestinal infections, obesity and other serious conditions and disorders linked to the gut microbiome.
The drug categories found to have the biggest impact on the microbiome include:
Proton pump inhibitors (PPIs)—used to treat dyspepsia, which affects between 11 percent and 24 percent of the European population. PPIs are also used to treat peptic ulcer, H. Pylori eradication, gastro reflux, and Barrett’s esophagus.
Metformin—used as a treatment for type 2 diabetes, affecting 10 percent of European adults
Antibiotics—used to treat bacterial infections, taken by 34 percent of the European population each year
Laxatives—used to treat and prevent constipation, affecting 17 percent of European adults
The gut microbiota of PPI users showed an increased abundance of upper gastrointestinal tract bacteria and increased fatty acid production, while metformin users had higher levels of the potentially harmful bacteria Escherichia coli (E. coli).
The researchers also found that an additional seven drug categories were associated with significant changes in bacterial populations in the gut.
The use of certain antidepressants (called SSRIs) by those with IBS was associated with an abundance of the potentially harmful bacteria species Eubacterium ramulus.
The use of oral steroids was associated with high levels of methanogenic bacteria which has been associated with obesity and an increase in BMI.
The study highlights the importance of considering the role of the gut microbiota when designing treatments and also points to new hypotheses that could explain certain side-effects associated with medication use.
The lead author of the study is Arnau Vich Vila.
The study was presented at UEG Week 2019.
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