Blunting the Effects of Antibiotics on the Intestinal Microbiome

Antibiotics have both short- and long-term effects on the intestinal microbiome, ranging from Clostridium difficile disease to diet-related obesity. Given these adverse effects, preservation of the intestinal microbiome from the dysbiosis that occurs during antibiotic therapy would be very useful. A French company has devised a product, DAV132, that delivers a nonspecific adsorbent, based on activated charcoal, to the late ileum. Previous animal and human studies have suggested that DAV132 decreases fecal concentrations of orally administered antibiotics without significantly affecting plasma pharmacokinetics.

Now, in this industry-sponsored, randomized clinical trial, 44 healthy volunteers received one of four treatments: MFX alone (once daily for 5 days), MFX + DAV132 (thrice daily for 7 days), DAV132 alone, or an inactive treatment similar to DAV132 (control).

Compared with the MFX-only group, fecal concentrations of MFX were decreased >99% in those on MFX + DAV132. Plasma concentrations of MFX in those on DAV132 were the same as those on MFX alone. Intestinal microbiome richness decreased to 54.6% of baseline at day 6 in volunteers who received only MXF. With coadministration of DAV132, this decrease was attenuated to values close to controls. The abundance of metagenomic species in the feces was decreased in those on MFX alone compared with the other groups. No adverse effects related to DAV132 were reported.