Contribution of Symptomatic, Herbal Treatment Options to Antibiotic Stewardship and Microbiotic Health

Abstract

Epithelial surfaces in humans are home to symbiotic microbes (i.e., microbiota) that influence the defensive function against pathogens, depending on the health of the microbiota. Healthy microbiota contribute to the well-being of their host, in general (e.g., via the gut-brain axis), and their respective anatomical site, in particular (e.g., oral, urogenital, skin, or respiratory microbiota). Despite efforts towards a more responsible use of antibiotics, they are often prescribed for uncomplicated, self-limiting infections and can have a substantial negative impact on the gut microbiota. Treatment alternatives, such as non-steroidal anti-inflammatory drugs, may also influence the microbiota; thus, they can have lasting adverse effects. Herbal drugs offer a generally safe treatment option for uncomplicated infections of the urinary or respiratory tract. Additionally, their microbiota preserving properties allow for a more appropriate therapy of uncomplicated infections, without contributing to an increase in antibiotic resistance or disturbing the gut microbiota. Here, herbal treatments may be a more appropriate therapy, with a generally favorable safety profile.

Keywords: NSAID; antibiotic stewardship; gut microbiota; herbal drugs; homeostasis; uncomplicated infection.

Figure 1

Changes in microbiome after treatment of mice with amoxicillin/clavulanic acid (day 7 and 84), moxifloxacin (day 7), BNO 2811 (day 7), or BNO 1011 (day 7), compared to a control group (water). (A) Similarity between individual bacterial compositions were studied using principal coordinates analysis (PCoA) of 16S rRNA gene sequencing data. Individual samples (colored dots) clustered well, according to the treatment groups. Ellipses represent the 95% confidence intervals, based on a multivariate t-distribution for each group. The center of each group is marked by small dots. Differential clustering of treatment groups after PCoA indicates compositional shifts after seven days of antibiotic treatment with amoxicillin/clavulanic acid (orange dots). Additional shifts of bacterial compositions 11 weeks after discontinuation of amoxicillin/clavulanic acid (d84, red triangles) point to a long-term damage of the microbiome, due to the antibiotic treatment. Bacterial compositions of mice treated with BNO 1011 and BNO 2811 showed high similarity to untreated mice, inferring no impact on the intestinal microbiome. Coordinates represent 41.4 and 16.1 percent variance of the dataset. (B) Taxonomy bar plot illustrating relative abundances of detected bacterial genera in samples and treatment groups.

Figure 1

Changes in microbiome after treatment of mice with amoxicillin/clavulanic acid (day 7 and 84), moxifloxacin (day 7), BNO 2811 (day 7), or BNO 1011 (day 7), compared to a control group (water). (A) Similarity between individual bacterial compositions were studied using principal coordinates analysis (PCoA) of 16S rRNA gene sequencing data. Individual samples (colored dots) clustered well, according to the treatment groups. Ellipses represent the 95% confidence intervals, based on a multivariate t-distribution for each group. The center of each group is marked by small dots. Differential clustering of treatment groups after PCoA indicates compositional shifts after seven days of antibiotic treatment with amoxicillin/clavulanic acid (orange dots). Additional shifts of bacterial compositions 11 weeks after discontinuation of amoxicillin/clavulanic acid (d84, red triangles) point to a long-term damage of the microbiome, due to the antibiotic treatment. Bacterial compositions of mice treated with BNO 1011 and BNO 2811 showed high similarity to untreated mice, inferring no impact on the intestinal microbiome. Coordinates represent 41.4 and 16.1 percent variance of the dataset. (B) Taxonomy bar plot illustrating relative abundances of detected bacterial genera in samples and treatment groups.

Figure 2

Changes in microbiome after treatment of mice with fosfomycin (day 2 after a single dose), nitrofurantoin (day 7), and BNO 2103 (day 7), compared to a control group (water, day 7). (A) Similarity between individual bacterial compositions were studied using principal coordinates analysis (PCoA) of 16S rRNA gene sequencing data. Individual samples (colored dots) clustered well, according to the treatment groups. Ellipses represent the 95% confidence intervals, based on a multivariate t-distribution for each group. The center of each group is marked by small dots. Differential clustering of samples after treatment with fosfomycin or nitrofurantoin indicates compositional shifts after antibiotic treatment of mice, while mice treated with BNO 2103 or controls are clustering together, denoting similar bacterial compositions. Coordinates represent 28 and 11 percent of total variance of the dataset. (B) Taxonomy bar plot illustrating relative abundance of detected bacterial genera in samples and treatment groups.