McCoubrey, LE; Basit, AW; (2022) Addressing drug–microbiome interactions: the role of healthcare professionals. Pharmaceutical Journal , 308 (7958) pp. 1-27. 10.1211/PJ.2022.1.126780.

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Abstract

Growing evidence has highlighted the potentially significant impact of drug–microbiome interactions on patient care. It is possible that hundreds of drugs alter the composition of the microbiome, including many drugs with non-microbial targets. Drug-induced alteration of the microbiome could increase patients’ risk of dysbiosis, a state of microbiome unbalance that increases the chance of disease. Further, a drug’s pharmacokinetics and pharmacodynamics can be altered by the microbiome via direct (e.g. biotransformation or bioaccumulation) and indirect processes. Although these interactions are potentially important for patient health and therapeutic success, they are rarely considered during drug development or in clinical practice. Healthcare professionals working across sectors should consider drug–microbiome interactions to improve patient outcomes. This review provides an overview of the current evidence relating to drug–microbiome interactions, and describes how healthcare professionals working in clinical settings, academia, policy and drug development can immediately begin to address drug–microbiome interactions as an integral part of their roles.

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