The biologic costs of antibiotic (over-) use in primary care

Rationale
The human microbiome is overly exposed to antibiotics, due, not only to their medical use, but also to their utilization in farms. Interest in the effect of antibiotic therapy on the host microbiota has increased, and new technologies are beginning to uncover the complexity and importance of balanced host-microbiota interactions. Microbiome composition can be rapidly altered by exposure to antibiotics, with potential immediate effect on the health (acute diseases) but it can also indirectly affect health in long term. In fact, antibiotic-induced microbiota alterations can remain after a long periods of time, spanning months and even years. The use of microbiome modulation to restore the human microbiome post antibiotic use might be a powerful strategy to improve resilience and health. Microbiota intervention strategies, including prebiotics, probiotics, nutrition and faecal transplant, might be effective strategies to conserve and steward the effects of antibiotics.

Aims & objectives
To determine: 1) antibiotic-induced changes in gut microbiota for the most commonly prescribed antibiotics in primary care; 2) strategies to restore the human microbiome after the use of antibiotics in primary care; 3) Perceptions of GPs and parents/patients on the risks of antibiotic use in terms of microbiome modulation in relation to clinical decision making and child development.

Methods
Systematic review methodology and qualitative interviews

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