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Antibiotics alter the gut microbiome, but researchers have discovered that metformin and other widely used nonantibiotic drugs can do the same (e.g., Nature 2015; 528:262).
To see how widespread this phenomenon might be, investigators screened 1000 drugs against 40 common and diverse gut bacterial strains (i.e., both gram-positive and gram-negative strains, and including potential pathogens such as Clostridium difficile). Surprisingly, 24% of the drugs, including members of all therapeutic classes, inhibited growth of at least one bacterial strain. Chemically diverse members of several therapeutic classes — antipsychotics, other psychoactive drugs, proton-pump inhibitors, antineoplastics, and hormones — were particularly likely to inhibit ba…