Gabriel Baldanzi, Anna Larsson, Sergi Sayols-Baixeras, Koen F. Dekkers, Ulf Hammar, Diem Nguyen, Tíscar Graells, Shafqat Ahmad, Camila Gazolla Volpiano, Guillaume Méric, Josef D. Järhult, Thomas Tängdén, Jonas F. Ludvigsson, Lars Lind, Johan Sundström, Karl Michaëlsson, Johan Ärnlöv, Beatrice Kennedy, Marju Orho-Melander, Tove Fall
Disruptions in gut microbiome are implicated in cardiometabolic disorders and other health outcomes. Antibiotics are known gut microbiome disruptors, but their long-term consequences remain underexplored. Here we combined individual-level data from the Swedish Prescribed Drug Register with fecal metagenomes of 14,979 adults to examine the association between oral antibiotic use over 8 years and gut microbiome. In multivariable confounder-adjusted regression models, antibiotic use <1 year before fecal sampling was associated with the greatest reduction in species diversity, but significant associations were also observed for use 1-4 and 4-8 years earlier. Clindamycin, fluoroquinolones and flucloxacillin accounted for most of the associations with the abundance of individual species. Use of these antibiotics 4-8 years earlier was associated with altered abundance of 10-15% of the species studied; penicillin V, extended-spectrum penicillins and nitrofurantoin were associated with only a few species. Similar results were found comparing one antibiotic course 4-8 years before sampling versus none in the past 8 years. These findings indicate that antibiotics may have long-lasting consequences for the gut microbiome.