Feature | Effect of antibiotics | Pathological consequence |
---|---|---|
Antibiotic resistance | Enrichment for resistance genes and resistant organisms [73]. In some cases, the rates of genetic exchange between microbes increase [178] | Multidrug-resistant tuberculosis. Carbapenem-resistant Escherichia coli infection [79] |
Vitamin production | Depletion of vitamin-producing bacteria | Broad-spectrum antibiotic use (especially β-lactams with an N-methylthiotetrazole moiety) can cause vitamin K deficiency leading to hypoprothrombinemia and uncontrolled bleeding [179] |
Digestion | Changes in the proportions of relevant metabolic functions in the microbiome [180] | Altered efficiency of nutrient extraction from food that can contribute to obesity [45, 59] |
Diversity | Reduced number of different microbes [68] | Lower diversity reduces ecological stability and resistance to pathogens. Increased susceptibility to infection and diarrhea [34, 46, 77, 78] |
Resilience | Decreased availability of microbes to take over newly open niches | Each course of antibiotic acts on a new ecology. Recovery to a stable state, and to a particular stable state, is highly individual [63] |
Immune regulation | Increased inappropriate immune activity | Asthma, allergies and autoimmune diabetes have all been linked to antibiotic use [6, 10, 61] |
Composition | Varying effects across taxa and for different durations |