Antibiotic-associated diarrhea (AAD) affects a significant proportion of patients receiving antibiotics. We sought to understand if differences in the gut microbiome would influence the development of AAD. We administered a 3-day course of amoxicillin-clavulanate to 30 healthy adult volunteers, and analyzed their stool microbiome, using 16S rRNA gene sequencing, at baseline and up to 4-weeks post-antibiotic administration. Lower levels of gut Ruminococcaceae were significantly and consistently observed from baseline till Day 7 in participants who developed AAD. Overall, participants who developed AAD experienced a greater decrease in microbial diversity. The probability of AAD could be predicted based on qPCR-derived levels of Faecalibacterium prausnitzii . Our findings suggest that a lack of gut Ruminococcaceae influences development of AAD. Quantification of F. prausnitzii in stool prior to antibiotic administration may help identify patients at risk of AAD, and aid clinicians in devising individualised treatment regimens to minimise such adverse effects.
Keywords: Antibiotic-associated diarrhea (AAD), amoxicillin-clavulanate, Gut microbiome, Ruminococcaceae, F. prausnitzii
Gu, Xiaoqiong and Sim, Jean XY and Lee, Wei Lin and Cui, Liang and Chan, Yvonne FZ and Chang, Ega Danu and Teh, Yii Ean and Zhang, An-Ni and Armas, Federica and Chandra, Franciscus and Hongjie, Chen and Zhao, Shijie and Lee, Zhanyi and Thompson, Janelle R. and Ooi, Eng Eong and Low, Jenny G. and Alm, Eric J. and Kalimuddin, Shirin, Gut Ruminococcaceae Levels Correlate with Risk of Antibiotic-Associated Diarrhea. Available at SSRN: https://ssrn.com/abstract=3942852 or http://dx.doi.org/10.2139/ssrn.3942852
This version of the paper has not been formally peer reviewed.