Impact of macrolide antibiotics on gut microbiota diversity with age-specific implications and scientific insights

Q2 Medicine Medicine in Microecology Pub Date : 2025-02-13 DOI:10.1016/j.medmic.2025.100122

H. Shayista , M.N. Nagendra Prasad , S. Niranjan Raj , Ashwini Prasad , S. Satish , H.K. Ranjini , K. Manju , Ravikumara , Raghuraj Singh Chouhan , Olga Y. Khohlova , Olga V. Perianova , S. Lakshmi , Syed Baker

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Abstract

This review investigates the effects of macrolides on the gut microbiota across different age groups. Macrolides, widely used to treat various infections, have been shown to disrupt the gut microbiome, leading to reduced bacterial diversity and increased risks of antibiotic resistance. The review examines the general mechanisms of action by macrolides, highlighting their role in inhibiting bacterial protein synthesis and promoting antibiotic resistance through horizontal gene transfer and selective pressure. Additionally, the reviews also focus on transition of gut microbiota across different age groups. It also addresses the dysbiotic shift induced by macrolides and its recovery following antibiotic discontinuation. Factors contributing to macrolides resistance, including genetic mutations and environmental factors, are discussed. The focus has been on alternative therapeutic approaches highlighted to mitigate resistance. Overall, the review provides a comprehensive overview of the implications associated with macrolides on gut health and offers insights into managing and minimizing resistance development.

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