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How antibiotic treatment impacts antibiotic resistance in the human gut microbiome remains poorly understood in vivo. Here, a total of 577 fecal samples from 233 heavily antibiotic-treated transplant patients were examined using high-resolution prescription data and shotgun metagenomics. The 13 most frequently used antibiotics were significantly associated with 154 (40% of tested associations) microbiome features. Use of broad-spectrum \u03b2-lactam antibiotics was most markedly associated with microbial disruption and increase in resistome features. The enterococcal vanA gene was positively associated with 8 of the 13 antibiotics, and in particular piperacillin\/tazobactam and vancomycin. Here, we highlight the need for a high-resolution approach in understanding the development of antibiotic resistance in the gut microbiome. Our findings can be used to inform antibiotic stewardship and combat the increasing threat of antibiotic resistance.<\/jats:p>","DOI":"10.1093\/infdis\/jiad033","type":"journal-article","created":{"date-parts":[[2023,2,6]],"date-time":"2023-02-06T15:21:56Z","timestamp":1675696916000},"page":"28-36","source":"Crossref","is-referenced-by-count":26,"title":["Impact of Antibiotic Treatment on the Gut Microbiome and its Resistome in Hematopoietic Stem Cell Transplant Recipients"],"prefix":"10.1093","volume":"228","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2400-0382","authenticated-orcid":false,"given":"Jens Christian","family":"N\u00f8rgaard","sequence":"first","affiliation":[{"name":"PERSIMUNE Centre of Excellence, Rigshospitalet , Copenhagen , Denmark"},{"name":"Department of Hematology, Rigshospitalet , Copenhagen , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mette","family":"J\u00f8rgensen","sequence":"additional","affiliation":[{"name":"PERSIMUNE 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