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However, little is known about the wider, potentially adverse impacts of these treatments. Substantial disruption of the upper airway commensal microbiota might reduce its contribution to host defense and local immune regulation, while increases in macrolide resistance carriage would represent a serious public health concern. Using samples from a randomized controlled trial, we show that low-dose erythromycin given over 48 weeks influences the composition of the oropharyngeal commensal microbiota. We report that macrolide therapy is associated with significant changes in the relative abundances of members of the\n            <jats:italic>Actinomyces<\/jats:italic>\n            genus and with significant increases in the carriage of transmissible macrolide resistance. Determining the clinical significance of these changes, relative to treatment benefit, now represents a research priority.\n          <\/jats:p>","DOI":"10.1128\/msphere.00103-18","type":"journal-article","created":{"date-parts":[[2018,4,17]],"date-time":"2018-04-17T09:54:03Z","timestamp":1523958843000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":50,"title":["Impact of Long-Term Erythromycin Therapy on the Oropharyngeal Microbiome and Resistance Gene Reservoir in Non-Cystic Fibrosis Bronchiectasis"],"prefix":"10.1128","volume":"3","author":[{"given":"Jocelyn M.","family":"Choo","sequence":"first","affiliation":[{"name":"Infection and Immunity, South Australia Health and Medical Research Institute, Adelaide, South Australia, Australia"},{"name":"SAHMRI Microbiome Research Laboratory, Flinders University School of Medicine, Adelaide, South Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guy C. 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