{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T22:31:50Z","timestamp":1790721110101,"version":"4.1.0"},"reference-count":122,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2017,12,5]],"date-time":"2017-12-05T00:00:00Z","timestamp":1512432000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2018,2]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Global prescription drug use has been increasing continuously for decades. The gut microbiome, a key contributor to health status, can be altered by prescription drug use, as antibiotics have been repeatedly described to have both short\u2010term and long\u2010standing effects on the intestinal microbiome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To summarise current findings on non\u2010antibiotic prescription\u2010induced gut microbiome changes, focusing on the most frequently prescribed therapeutic drug categories.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a systematic review by first searching in online databases for indexed articles and abstracts in accordance with\n                      <jats:styled-content style=\"fixed-case\">PRISMA<\/jats:styled-content>\n                      guidelines. Studies assessing the intestinal microbiome alterations associated with proton pump inhibitors (\n                      <jats:styled-content style=\"fixed-case\">PPI<\/jats:styled-content>\n                      s), metformin, nonsteroidal anti\u2010inflammatory drugs (\n                      <jats:styled-content style=\"fixed-case\">NSAID<\/jats:styled-content>\n                      s), opioids, statins and antipsychotics were included. We only included studies using culture\u2010independent molecular techniques.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Proton pump inhibitors and antipsychotic medications are associated with a decrease in \u03b1 diversity in the gut microbiome, whereas opioids were associated with an increase in \u03b1 diversity. Metformin and\n                      <jats:styled-content style=\"fixed-case\">NSAID<\/jats:styled-content>\n                      s were not associated with significant changes in \u03b1 diversity. \u03b2 diversity was found to be significantly altered with all drugs, except for\n                      <jats:styled-content style=\"fixed-case\">NSAID<\/jats:styled-content>\n                      s.\n                      <jats:styled-content style=\"fixed-case\">PPI<\/jats:styled-content>\n                      use was linked to a decrease in Clotridiales and increase in Actinomycetales, Micrococcaceae and Streptococcaceae, which are changes previously implicated in dysbiosis and increased susceptibility to\n                      <jats:italic>Clostridium difficile<\/jats:italic>\n                      infection. Consistent results showed that\n                      <jats:styled-content style=\"fixed-case\">PPI<\/jats:styled-content>\n                      s, metformin,\n                      <jats:styled-content style=\"fixed-case\">NSAID<\/jats:styled-content>\n                      s, opioids and antipsychotics were either associated with increases in members of class Gammaproteobacteria (including\n                      <jats:italic>Enterobacter<\/jats:italic>\n                      ,\n                      <jats:italic>Escherichia<\/jats:italic>\n                      ,\n                      <jats:italic>Klebsiella<\/jats:italic>\n                      and\n                      <jats:italic>Citrobacter<\/jats:italic>\n                      ), or members of family Enterococcaceae, which are often pathogens isolated from bloodstream infections in critically ill patients. We also found that antipsychotic treatment, usually associated with an increase in body mass index, was marked by a decreased ratio of Bacteroidetes:Firmicutes in the gut microbiome, resembling trends seen in obese patients.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Non\u2010antibiotic prescription drugs have a notable impact on the overall architecture of the intestinal microbiome. Further explorations should seek to define biomarkers of dysbiosis induced by specific drugs, and potentially tailor live biotherapeutics to counter this drug\u2010induced dysbiosis. Many other frequently prescribed drugs should also be investigated to better understand the link between these drugs, the microbiome and health status.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/apt.14451","type":"journal-article","created":{"date-parts":[[2017,12,5]],"date-time":"2017-12-05T06:58:46Z","timestamp":1512457126000},"page":"332-345","source":"Crossref","is-referenced-by-count":217,"title":["Systematic review: human gut dysbiosis induced by non\u2010antibiotic prescription medications"],"prefix":"10.1111","volume":"47","author":[{"given":"Q.","family":"Le Bastard","sequence":"first","affiliation":[{"name":"MiHAR Lab Institut de Recherche en Sant\u00e9 2 Universit\u00e9 de Nantes Nantes France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. 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