Antibiotic may cause short-term perturbation of gut microbiota and emergence of antibiotic resistance. However, relatively few studies addressed on the long-term impacts of antibiotics on the composition of gut microbiota. A large cohort study in Finnish children showed that macrolides may induce long-term alteration of fecal microbiota, including the reduction of Actinobacteria (mainly Bifidobacteria), Firmucutes (mainly Lactobacillus) and the total bacterial diversity. Recent studies showed that eradication of H. pylori resulted in an increase in the bacterial diversity and restoration of the relative abundance of other bacteria to levels similar to H. pylori non-infected subjects in the gastric microbiota. The administration of antibiotics may also alter the composition of intestinal microbiota. However, the relative abundances of all phyla were restored at 8 weeks after treatment. Our recent randomized trial showed that the diversity of gut microbiota was significantly perturbed immediately after triple, concomitant, and quadruple therapies, but to a greater extent for concomitant therapy and quadruple therapy. The diversity was restored at week 8 and 1 year for triple therapy, but was not yet fully recovered at 1 year for concomitant and quadruple therapies. Some studies showed that insulin resistance, fasting glucose, total cholesterol, and triglyceride levels were reduced after H. pylori eradication. The changes in these metabolic parameters might be attributed to the alterations in gut microbiota. However, these findings remain controversial and further well-designed randomized trials are warranted to clarify the impact of H. pylori eradication on metabolic parameters.
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