The influence of proton pump inhibitors and other commonly used medication on the gut microbiota

Abstract

Proton pump inhibitors (PPIs), used to treat gastro-esophageal reflux and prevent gastric ulcers, are among the most widely used drugs in the world. The use of PPIs is associated with an increased risk of enteric infections. Since the gut microbiota can, depending on composition, increase or decrease the risk of enteric infections, we investigated the effect of PPI-use on the gut microbiota. We discovered profound differences in the gut microbiota of PPI users: 20% of their bacterial taxa were statistically significantly altered compared with those of non-users. Moreover, we found that it is not only PPIs, but also antibiotics, antidepressants, statins and other commonly used medication were associated with distinct gut microbiota signatures. As a consequence, commonly used medications could affect how the gut microbiota resist enteric infections, promote or ameliorate gut inflammation, or change the host's metabolism. More studies are clearly needed to understand the role of commonly used medication in altering the gut microbiota as well as the subsequent health consequences.

Keywords: gut microbiota; medication; proton pump inhibitors.

Figure 1.

Inter-individual gut microbiota variation (Bray-Curtis distance) explained by commonly used medication at FDR < 0.1. Figure from Zhernakova et al. Science 2016. © Science. Reproduced by permission of Science. Permission to reuse must be obtained from the rightsholder.

Figure 2.

Gut microbiota changes associated with PPI use that increase the risk of Clostridium difficile infection.