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Review
. 2025 Dec;57(1):2478317.
doi: 10.1080/07853890.2025.2478317. Epub 2025 Mar 17.

Exploring the role of gut microbiota in antibiotic resistance and prevention

Devyani S Dongre  1 , Ujjayni B Saha  1 , Sunil D Saroj  1
Affiliations
Review

Exploring the role of gut microbiota in antibiotic resistance and prevention

Devyani S Dongre et al. Ann Med. 2025 Dec.

Abstract

Background/introduction: Antimicrobial resistance (AMR) and the evolution of multiple drug-resistant (MDR) bacteria is of grave public health concern. To combat the pandemic of AMR, it is necessary to focus on novel alternatives for drug development. Within the host, the interaction of the pathogen with the microbiome plays a pivotal role in determining the outcome of pathogenesis. Therefore, microbiome-pathogen interaction is one of the potential targets to be explored for novel antimicrobials.

Main body: This review focuses on how the gut microbiome has evolved as a significant component of the resistome as a source of antibiotic resistance genes (ARGs). Antibiotics alter the composition of the native microbiota of the host by favouring resistant bacteria that can manifest as opportunistic infections. Furthermore, gut dysbiosis has also been linked to low-dosage antibiotic ingestion or subtherapeutic antibiotic treatment (STAT) from food and the environment.

Discussion: Colonization by MDR bacteria is potentially acquired and maintained in the gut microbiota. Therefore, it is pivotal to understand microbial diversity and its role in adapting pathogens to AMR. Implementing several strategies to prevent or treat dysbiosis is necessary, including faecal microbiota transplantation, probiotics and prebiotics, phage therapy, drug delivery models, and antimicrobial stewardship regulation.

Keywords: Gut microbiota; antimicrobial resistance; dysbiosis; multidrug-resistant bacteria; quorum sensing.

Plain language summary

The gut microbiota is crucial for developing local and systemic immunity and prevents a wide array of bacterial infections.Numerous factors, such as antibiotic use, physical and mental stress, radiation, gastrointestinal infections, dietary changes, pollution, hospital exposure, etc., can damage the beneficial gut microbiota.Influx of substantial inoculums of highly pathogenic bacteria can overwhelm the body defence systems, disrupt the balance of the gut microbiome, and cause various clinical symptoms.Knowledge about the interactions between the microbiota and the host, microbial quorum sensing, and the elements that lead to colonization resistance, it will be possible to eradicate pathogenic bacteria based on their preference and preserve gut microbiota homeostasis with minimal disturbance.

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Conflict of interest statement

No potential conflict of interest was reported by the authors.

Figures

Figure 1.
Figure 1.
Role of quorum sensing mechanisms in the development of AMR of pathogens in gut microbiota. Bacterial communication via quorum sensing (QS) influences antimicrobial resistance (AMR) in gut pathogens. QS signalling molecules regulate gene expression in bacterial populations, leading to biofilm formation, efflux pump expression, etc., promoting horizontal gene transfer (HGT) of resistance genes and factors like antibiotics shape QS-mediated AMR development.
Figure 2.
Figure 2.
Recent advancements in drug delivery systems to overcome dysbiosis and AMR development by pathogens in gut microbiome. The image illustrates strategies for targeted therapy in gut health like nanoparticles, dendrimers, liposomes, micelle, niosome, phytosomes, mesoporous nanoparticles, carbon nanotube, nanoemulsion, quantum dot, hydrogel, aerogel, drug-loaded microsphere.
See this image and copyright information in PMC

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