title: Antibiotics as deep modulators of gut microbiota: between good and evil.
abstract: The recent increase in our knowledge of human gut microbiota has changed our view on antibiotics. Antibiotics are, indeed, no longer considered only beneficial, but also potentially harmful drugs, as their abuse appears to play a role in the pathogenesis of several disorders associated with microbiota impairment (eg,Clostridium difficileinfection or metabolic disorders). Both drug-related factors (such as antibiotic class, timing of exposure or route of administration) and host-related factors appear to influence the alterations of human gut microbiota produced by antibiotics. Nevertheless, antibiotics are nowadays considered a reliable therapy for some non-communicable disorders, including IBS or hepatic encephalopathy. Moreover, some antibiotics can also act positively on gut microbiota, providing a so-called 'eubiotic' effect, by increasing abundance of beneficial bacteria. Therefore, antibiotics appear to change, for better or worse, the nature of several disorders, including IBS, IBD, metabolic disorders or liver disease. This reviews aims to address the potential of antibiotics in the development of major non-communicable disorders associated with the alteration of gut microbiota and on newly discovered therapeutic avenues of antibiotics beyond the cure of infectious diseases.
authors.affiliation: Internal Medicine, Gastroenterology and Liver Unit, "Agostino Gemelli" University Hospital, Catholic University of Rome, Italy.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Ianiro
authors.affiliation: Department of Internal Medicine I, Gastroenterology, Endocrinology & Metabolism, Medical University Innsbruck, Innsbruck, Austria.
authors.forename: Herbert
authors.initials: H
authors.lastname: Tilg
authors.affiliation: Internal Medicine, Gastroenterology and Liver Unit, "Agostino Gemelli" University Hospital, Catholic University of Rome, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Gasbarrini
mesh_terms: D000900:Anti-Bacterial Agents / Q000009:adverse effects* / Q000145:classification / Q000627:therapeutic use; D000069196:Gastrointestinal Microbiome / Q000187:drug effects* / Q000502:physiology; D006801:Humans
chemical_list: D000900:Anti-Bacterial Agents
keywords: ANTIBIOTICS; INTESTINAL BACTERIA; INTESTINAL MICROBIOLOGY; OBESITY