ArticleMicrobiology spectrum2023
The Impact of Long-Term Macrolide Exposure on the Gut Microbiome and Its Implications for Metabolic Control.
Article in Microbiology spectrum, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
What it found
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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
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 13 citations in OpenAlex.
- Early-life antibiotic exposure and type 1 diabetes risk: a systematic review and meta-analysis.Frontiers in endocrinology · 2026Pooled it
- Effect of low dose azithromycin on the fecal microbiome and fecal bile acids in healthy dogs.Journal of veterinary internal medicine · 2026Article
- Impact of the anti-inflammatory macrolide glasmacinal on the gut microbiota of healthy adults: an open-label trial.Nature communications · 2026Article
- Antibiotic-induced gut microbiome dysbiosis: risks and strategies for mitigation.The EMBO journal · 2026Review
- Veterinary Drug Residues in Food Chains: Sources, Exposure Pathways, Health Impacts, Mitigation, and Safety Assurance.Foods (Basel, Switzerland) · 2026Review
- The hidden cost of antibiotics: microbial dysbiosis-induced SCFA imbalance and its underlying mechanisms.Frontiers in immunology · 2026Review
- The microbiome and gut-lung axis in nontuberculous mycobacterial pulmonary disease.PLoS pathogens · 2025Review
- Increased macrolide resistance in Streptococcus pneumoniae in Slovakia may be linked to increased macrolide consumption.Central European journal of public health · 2025Article
- Complexity of antibiotic resistance and its impact on gut microbiota dynamics.Engineering microbiology · 2025Review
- Microbiota and antibiotic exposure in sarcoidosis.Frontiers in immunology · 2025Review
- Effect of preconception antibiotics exposure on female reproductive health and pregnancy outcomes: a systematic review and meta-analysis.EClinicalMedicine · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
13 authors at 4 institutions in 2 countries.
Funding
Abstract
Long-term low-dose macrolide therapy is now widely used in the treatment of chronic respiratory diseases for its immune-modulating effects, although the antimicrobial properties of macrolides can also have collateral impacts on the gut microbiome. We investigated whether such treatment altered intestinal commensal microbiology and whether any such changes affected systemic immune and metabolic regulation. In healthy adults exposed to 4 weeks of low-dose erythromycin or azithromycin, as used clinically, we observed consistent shifts in gut microbiome composition, with a reduction in microbial capacity related to carbohydrate metabolism and short-chain fatty acid biosynthesis. These changes were accompanied by alterations in systemic biomarkers relating to immune (interleukin 5 [IL-5], IL-10, monocyte chemoattractant protein 1 [MCP-1]) and metabolic (serotonin [5-HT], C-peptide) homeostasis. Transplantation of erythromycin-exposed murine microbiota into germ-free mice demonstrated that changes in metabolic homeostasis and gastrointestinal motility, but not systemic immune regulation, resulted from changes in intestinal microbiology caused by macrolide treatment. Our findings highlight the potential for long-term low-dose macrolide therapy to influence host physiology via alteration of the gut microbiome.
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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.