A review by the Medicines and Healthcare products Regulatory Agency (MHRA) and the University of Glasgow has found that almost all medicines have the potential to influence gut bacteria and that can affect how other treatments work.
The joint review titled “Nature npj Antimicrobials and Resistance,” was conducted by Shirley Do Nascimento and colleagues.
They found that any medication, including antibiotics, diabetes medicines, antipsychotics, etc. can alter the make-up of trillions of bacteria in the digestive system that keep us healthy.
They could affect how medicines work in the body, particularly when treatments are taken together.
The gut microbiome plays a key role in immunity and metabolism.
While the effects of antibiotics on this balance are well established, the review highlights that several non-antibiotic medicines too could affect them.
When the balance of gut bacteria is disrupted, resistant bacteria can gain an advantage.
The knowledge is important to design treatments specifically for each patient, and to comprehend why each patient respond differently to medicines.
Identifying medicines that are less disruptive to the microbiome could also help slow the spread of antimicrobial resistance.
“These findings could help researchers understand why some patients respond differently to the same treatment, and why certain side effects occur in some people but not others,” Dr Chrysi Sergaki, senior author of the study and head of Microbiome at the MHRA.
The long term goal of the review is the development of tools to help doctors understand how combinations of medicines affect people in real life, so that they can formulate safer, more effective prescribing.
Dr Anastasia Theodosiou, co-author of the paper at the University of Glasgow, said, “This paper is an important step towards recognising the microbiome as something we need to protect - and towards designing and testing medicines that are not only more effective, but also safer for our microbiomes.”
The aim is to build consistent and reliable evidence that can be used by regulators and the developers.
