After antibiotic pills, our intestinal flora is no longer the same - but you can do that!

After antibiotic pills, our intestinal flora is no longer the same - but you can do that!

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Antibiotics leave permanent traces in the gut microbiome

Our intestinal flora, now known as the intestinal microbiome, contains billions of tiny organisms that live in a balanced environment and have important tasks in digestion and maintaining health. A team of international researchers recently investigated what happens when this balance is destroyed and how the intestinal flora subsequently builds up again.

Broad-spectrum antibiotics are mostly used when other antibiotics fail. The antibacterial club not only kills pathogens, a large part of the intestinal microbiome is also destroyed as a result of such medication. Together with international colleagues, researchers at the Max Delbrück Center for Molecular Medicine (MDC) investigated how the intestinal flora gradually recovers after such a stroke. The results were recently published in the journal "Nature Microbiology".

Each gut contains its own microcosm

The MDC researchers estimate that there are as many bacteria in every human gut as there are humans on earth. In most cases, the tiny creatures are useful for the good of the owner. For example, they support the digestion of food, produce vitamins, train the immune system and protect against disease-causing peers.

A fragile thing

Diseases or medication can unbalance or even destroy this susceptible structure. "If it gets out of balance, there is a risk of infectious diseases, obesity and diabetes as well as inflammatory bowel diseases or neurological diseases", reports research director Dr. Sofia Forslund in a press release. Her team now researched the complex interactions between humans and microbiomes.

Antibiotics permanently change the intestinal flora

Together with researchers from Denmark, Germany and China, the team around Forslund investigated how serious treatment with broad-spectrum antibiotics affects the fragile interaction of the intestinal bacteria. According to the study team, it takes up to half a year for the intestinal flora to recover. However, the research group was unable to determine a complete regeneration. "Some sensitive types of bacteria have disappeared permanently," said Forslund.

About the course of the study

During the tests, twelve healthy men agreed to take a cocktail of the three antibiotics meropenem, gentamicin and vancomycin for four days. Her gut microbiome was then analyzed for six months. Not only was the presence of the individual bacterial species recorded, but their genes were also determined using DNA sequencing.

Even after antibiotics were administered, the intestine was not sterile

The first surprise came shortly after the medication. As the researchers report, some bacteria even survived the potent antibiotics. Among the survivors, the scientific team found some previously unknown and as yet unspecified species. Other types of bacteria turned into spores. In this life form, the bacteria can remain in bad conditions for a long time.

How the gut is slowly recovering

As the regeneration phase progressed, the second surprise emerged. The first bacteria to re-colonize the intestine were mainly to be attributed to the pathogenic strains, such as Enterococcus faecalis and Fusobacterium nucleatum. "This observation explains well why most antibiotics cause gastrointestinal disorders," concludes Forslund.

Lactic acid bacteria ensure the turn

Over time, the pathogenic strains are increasingly being replaced by useful bacteria, such as lactic acid-producing bifidobacteria, the researchers report. After six months, the intestinal flora was intact again - but not quite the same as before. Some types of bacteria were missing and never returned. "As expected, the number of resistance genes in the bacteria also increased," explains Forslund.

Be more careful when dealing with antibiotics

"Due to the apparently permanent loss of individual species and the increased number of resistance genes, the study shows once again how important it is to administer antibiotics carefully," summarizes the expert. Now you have to find out how it can be better to protect the sensitive intestinal flora from antibiotics. Further information on the structure and intestinal rehabilitation can be found in the articles "Building intestinal flora: how it works" and "The 10 best tips for intestinal rehabilitation". (vb)

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