It is already well known that antibiotics are disruptors of the intestinal microbiota in the short term. For this reason, their uses remain limited in time. But what about the long term?
A study carried out by Swedish and Australian researchers, published in the scientific journal Naturecombined individual data on almost 15,000 adults from the Swedish Medicines Register to examine theassociation between taking different antibiotics and the consequences on the intestinal flora in the long term.
Four classes of antibiotics particularly impact the intestinal microbiota
During the study, the researchers classified the different antibiotics based on the duration and intensity of their impact on the intestinal flora. Four of them particularly stand out.
Clindamycine (Cleocin®), an antibiotic used to treat bacterial skin infections such as erysipelas, skin abscesses or boils. Of all the antibiotics tested in the study, this one “was associated with an average reduction of 47 species detected. Its impact on the diversity of intestinal flora remains significant up to 4 years after taking ».
THE fluoroquinolonesused to treat serious infections that can be life-threatening, and flucloxacillinesuseful during cardiovascular and orthopedic surgery operations, “are associated with a reduction in diversity of at least 20 species, which may persist for 4 to 8 years after treatment ».
And finally, the tetracyclineused to treat various sexually transmitted infections, or in cases of severe acne, also shows “long-lasting associations with a reduced diversity of flora, up to 4 to 8 years after its use”.
Conversely, other antibiotics have been shown to be less restrictive on the intestinal flora of patients, such as penicillin V, expanded spectrum penicillins or nitrofurantoin. The latter had “very little long-term association with microbiome composition,” the researchers said.
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The exceptional persistence of certain antibiotics worries researchers
As part of the study, scientists understood that “ a single cycle of these specific antibiotics is enough to influence the diversity and abundance of certain species in the microbiome at the time of sampling, i.e. 4 to 8 years after capture.
The natural recovery of the human body seems to be faster during the first two years after stopping treatment, but after this time it slows down significantly.
For researchers, these persistent alterations are worrying, “because they concern species linked to metabolic health, to the risk of type 2 diabetesto cardiovascular diseases and to inflammatory bowel diseases ».
How to restore your intestinal flora after taking an antibiotic?
Researchers say the answer varies greatly from person to person. But the natural recovery of the intestinal flora can be helped by external factors.
Food is the first key that can explain the variability of the microbiome from one person to another. Environmental exposure, thanks to colonization of external bacterial strains, can also influence the composition of the flora during its recovery phase.
However, scientists assure that “it is better to choose an antibiotic with less impact on the intestinal flora and to reduce their use as much as possible”.
