The Impact of Long-Term Macrolide Exposure on the Gut Microbiome and Its Implications for Metabolic Control
Jocelyn M. Choo, Alyce M. Martin, Steven Taylor, Emily Sun, Fredrick M. Mobegi, Tokuwa Kanno, Alyson Richard, Lucy Burr, Stevie Lingman, Megan Martin, Damien J. Keating, A. James Mason, Geraint B. Rogers
Abstract
Long-term macrolide therapy is widely used in chronic respiratory diseases although its antibacterial activity can also affect the gut microbiota, a key regulator of host physiology. Macrolide-associated studies on the gut microbiota have been limited to short antibiotic courses and have not examined its consequences for host immune and metabolic regulation. This study revealed that long-term macrolides depleted keystone bacteria and impacted host regulation, mediated directly by macrolide activity or indirectly by alterations to the gut microbiota. Understanding these macrolide-associated mechanisms will contribute to identifying the risk of long-term exposure and highlights the importance of targeted therapy for maintenance of the gut microbiota.