SynthesisBMJ open2020
Antibiotic-induced changes in the human gut microbiota for the most commonly prescribed antibiotics in primary care in the UK: a systematic review.
Synthesis in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 137 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
137 citing papers in PubMed, 5 syntheses or guidelines pooled it, 215 citations in OpenAlex.
- Bioregulatory periodontal medicine: could the molecular networks, inflammation and system biology modify the auto-regulatory capacity of the patients?Frontiers in physiology · 2026Pooled it
- The impact ofFrontiers in cellular and infection microbiology · 2025Pooled it
- Pooled it
- Pooled it
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- The impact of topical or oral antibiotics in children with acute otitis media on their middle ear, nasopharyngeal, and gut microbiomes.Epidemiology and infection · 2026Trial
- Probiotic intervention not beneficial to prevent antibiotic-associated diarrhea in absence of antibiotic-induced microbiome disruption.Scientific reports · 2026Trial
- Patient perceptions of primary care rapid respiratory microbiological point-of-care testing: a qualitative study.BMJ open · 2025Trial
- Higher alpha diversity and Lactobacillus blooms are associated with better engraftment after fecal microbiota transplant in inflammatory bowel disease.Scientific reports · 2024Trial
- Doxycycline host-directed therapy in human pulmonary tuberculosis.The Journal of clinical investigation · 2021Trial
- Antibiotic-Driven Gut Microbiome Dysbiosis: Resistome Dynamics, Metabolic Disruption, and Paths to Restoration.Antibiotics (Basel, Switzerland) · 2026Review
- Article
- Antibiotic-Induced Manic Episodes: Clinical Recognition, Mechanistic Pathways, and Management.Cureus · 2026Review
- Gut Microbiome in Obesity: A Narrative Review of Mechanisms, Interventions, and Future Directions.Probiotics and antimicrobial proteins · 2026Review
- The Role of the Gut Microbiota and Uraemic Toxins in Vaccine Responsiveness Among People Receiving Maintenance Haemodialysis.Vaccines · 2026Article
- Antibiotic use and gut microbiome composition links from individual-level prescription data of 14,979 individuals.Nature medicine · 2026Article
- The Microbiota-Gut-Brain Axis in Insomnia: Mechanisms and Intervention Strategies.Life (Basel, Switzerland) · 2026Review
- COVID-19 Infection and Gut Microbial Dysbiosis Among Filipinos with Type 2 Diabetes Mellitus.Journal of the ASEAN Federation of Endocrine Societies · 2026Article
- Gut microbiome-driven modulation of the tumor immune microenvironment optimizes dual checkpoint blockade in advanced non-small-cell lung cancer.ESMO open · 2026Article
- Dietary intake of enrofloxacin promotes the spread of antibiotic resistance from food to simulated human gut.The ISME journal · 2026Article
77 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThe gut microbiota influences many aspects of human health. We investigated the magnitude and duration of changes in gut microbiota in response to antibiotics commonly prescribed in UK primary care.
methodsWe searched MEDLINE, EMBASE and AMED, all years up to May 2020 including all study designs, collecting and analysing data on the effect of antibiotics prescribed for respiratory and urinary tract infections. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Cochrane standard methods. Risk of bias was evaluated using the Critical Appraisal Skills Programme. Narrative synthesis was used to report the themes emerging from the data.
main outcome measuresPrimary outcomes were antibiotic-induced changes in the composition and/or diversity of the gut microbiota. Secondary outcome was the time for the microbiota to return to baseline.
resultsThirty-one articles with low or unclear risk of bias showed that antibiotics impact the gut microbiota by causing rapid and diminished levels of bacterial diversity and changes in relative abundances. After cessation of treatment, gut bacteria recover, in most individuals, to their baseline state within a few weeks. Some studies suggested longer term effects from 2 to 6 months. Considerable heterogeneity in methodology makes the studies prone to biases and other confounding factors. Doxycycline was associated with a marked short-term decrease in
conclusionsDespite substantial heterogeneity of the studies and small sample sizes, there is evidence that antibiotics commonly used in primary care influence the composition of the gastrointestinal microbiota. Larger population-based studies are needed to fully understand how antibiotics modulate the microbiota, and to determine if these are associated with (longer term) health consequences. PROSPERO REGISTRATION NUMBER: CRD42017073750.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.