Shahi Farah, Redeker Kelly, Chong James
Department of Infection, Hull University Teaching Hospitals NHS Trust, Castle Hill Hospital, Cottingham, HU16 5JQ, UK.
Department of Biology, University of York, Wentworth Way, Heslington, YO10 5DD, UK.
JAC Antimicrob Resist. 2019 May 21;1(1):dlz015. doi: 10.1093/jacamr/dlz015. eCollection 2019 Jun.
Ongoing concerns over the presence and persistence of antimicrobial resistance (AMR), particularly in Gram-negative bacteria, continue to have significant global health impacts. The gastrointestinal tract, or 'gut', environment amplifies AMR in the human gut microbiome, even in the absence of antibiotics. It constitutes a complex and diverse community of organisms, and patterns and alterations within it are increasingly being found to be associated with states of health and disease. Our understanding of the effects of routes of administration of antimicrobials on the gut microbiome is still lacking despite recent advances in metagenomics. In this article we review current evidence for antibiotic effects on gut microbiota and explore possible prescribing and stewardship approaches that would seek to minimize these effects. If we are to preserve existing and new antimicrobials, we need to consider their use in the context of their effect on gut ecology, and the human microbiome in general.
对抗菌素耐药性（AMR）的存在和持续存在，尤其是革兰氏阴性菌中的耐药性，持续存在的担忧继续对全球健康产生重大影响。胃肠道，即“肠道”环境，即使在没有抗生素的情况下，也会在人类肠道微生物群中加剧抗菌素耐药性。它构成了一个复杂多样的生物体群落，并且越来越多地发现其中的模式和变化与健康和疾病状态相关。尽管宏基因组学最近取得了进展，但我们对抗菌素给药途径对肠道微生物群的影响仍缺乏了解。在本文中，我们回顾了抗生素对肠道微生物群影响的现有证据，并探讨了可能的处方和管理方法，这些方法旨在尽量减少这些影响。如果我们要保留现有的和新的抗菌药物，我们需要在其对肠道生态以及总体人类微生物群的影响的背景下考虑它们的使用。
