Post-Antibiotic Gut Mucosal Microbiome Reconstitution Is Impaired by Probiotics and Improved by Autologous FMT.
Level 2 - randomized trial
Controlled clinical trial in humans combined with murine and in vitro models
PubMed 30193113 · doi:10.1016/j.cell.2018.08.047
What was done
Invasively evaluated the effects of multi-strain probiotics versus autologous fecal microbiome transplantation (aFMT) versus spontaneous recovery on post-antibiotic reconstitution of the mucosal microbiome niche and host transcriptome in humans and mice. In vitro assays were also conducted to evaluate mechanisms of probiotic-mediated microbial inhibition.
What was found
The abstract reports no numerical values, effect sizes, or confidence intervals. Directionally, antibiotic exposure enhanced probiotic colonization in the human mucosa. Compared to spontaneous recovery, probiotics caused markedly delayed and persistently incomplete reconstitution of indigenous stool and mucosal microbiota and host transcriptome recovery. Conversely, aFMT produced rapid and near-complete recovery within days. In vitro testing indicated that Lactobacillus-secreted soluble factors contributed to probiotic-induced microbiome inhibition.
Why it matters
Commonly prescribed post-antibiotic probiotic supplementation may paradoxically impede indigenous mucosal microbiome and host recovery rather than aid it, whereas autologous FMT supports rapid restoration.
Limits
The abstract omits human and murine sample sizes, participant demographics, antibiotic regimens, specific probiotic compositions and doses, precise follow-up duration, and quantitative data. Direct clinical outcomes beyond mucosal and stool recovery metrics were not described.
Cited by
- partial Antibiotic administration clears the indigenous microbiome, permitting supplemental probiotics to colonize the gut in humans and mice.
- supports Administering probiotics following antibiotic exposure persistently inhibits the natural recolonization and reconstitution of the indigenous gut microbiome.