LONDON, Dec. 23 -- The government of the United Kingdom issued the following news:
Someeveryday medicines - not just antibiotics - couldinfluencegut bacteria in ways that affect how other treatments work, according to a new review by the Medicines and Healthcare products Regulatory Agency (MHRA)and University of Glasgow.The findingsopen upopportunities to better tailor treatments to individuals and improve how medicines are used together in real life.
The review, published today (23December) inNature npj Antimicrobials and ResistancebyShirleyDo Nascimento andcolleagues,brings togetherevidence that a wide range of drugs - including diabetes treatments and antipsychotics - can change the make-up ofthe trillions ofbacteria inourgutthat keep us healthy. Thesesubtlechanges couldplay a role in how medicines work inthe body, particularly when treatments are taken together.
Understanding how drugs interact with gut bacteria could helpresearchers and the MHRA build on the strong existing evidence base around medicine safety,better understandwhy some peoplerespond differently to the same medicine,andsupport the development oftreatments that areevensafer andmoreeffectiveover time.
Dr Chrysi Sergaki,seniorauthor of the study and Head of Microbiome at the MHRA, said:
"Antibiotics are well known to affect gut bacteria, but this review shows thatsomeother common medicines can also influence the microbiome. Building this understanding helps usidentifywhere better data could improve drug development and, ultimately, patientcare - while also supporting the responsible use of antibiotics.
"These findings could help researchers understand why some patients respond differently to the same treatment, and why certain side effects occur in some people but not others."
The gut microbiome - the community of trillions of bacteria that live in the digestive system - plays a key role in immunity and metabolism. While the effects of antibiotics on this balance are well established, the review highlights evidence that several non-antibiotic medicines may have similar, if more subtle, effects.
For example, the reviewhighlightsthat:
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Metformin, a widely used diabetes medicine, alters gut bacteria in ways that may contribute to both its benefits and some side effects, such as bloating or diarrhoea.
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Antipsychotic medicines have been shown in studies to disrupt gut bacteria linked to weight gain and metabolic changes.
Better understanding of how medicines affect gut bacteria could also support efforts toprotect the effectiveness of treatments, including antibiotics.The gut is a major home for bacteriaand other microorganisms, including those carrying resistance genes. When the balance of gut bacteria is disrupted, resistant bacteria can gain an advantage.Identifyingmedicines that are less disruptive to the microbiome could, over time,help slow the spread ofantimicrobialresistance.
Dr Anastasia Theodosiou, co-author of the paper at the University of Glasgow, said:
"This paper isan important steptowards recognising the microbiome as something we need to protect - and towards designing and testing medicines that are not only more effective, but also safer for our microbiomes."
The MHRA is working with researchers and innovators to developupdatedstandards for studying how medicines affect the gut microbiome - and other microbiomes, such as thevaginal microbiome- during drug development, whereappropriate. The aim is to build consistent, reliable evidence that can be used by regulators and developers alike.
The MHRA is also exploring new ways to improve how side effects and interactions between medicines are predicted. This includes:
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TheYellow Card Biobank, which links reports of suspected side effects to genetic and biological data, helping researchers better understand why some people experience adverse reactions.
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A newstudy using AI and anonymised NHS data topredict potential side effects from combinations of medicines before they reach patientsisparticularly important as millions of people in the UK take multiple medicines, and some interactions can lead toavoidable side effects, extra GP visits or hospital stays.
The long-term goal is to develop tools that help doctors understand how combinations of medicines affect people in real life, supporting safer, more effective prescribing that can bemore closelytailored to individual patients.
Patientsshould keep taking their medicines as prescribed.Do not stop or alter your treatment without speaking to a healthcare professional. If you have any concerns or questions, seek advice from your doctor or pharmacist, and report any suspected side effects viatheYellow Card scheme.
Notes to editors
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Publication:S. Do Nascimentoet al. (2025) 'Microbiotoxicity: An under-recognised player in drug efficacy, toxicity, and health outcomes'Nature npj Antimicrobials and Resistance.DOI:10.1038/s44259-025-00165-5.
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The Medicines and Healthcare products Regulatory Agency (MHRA)is responsible forregulating all medicines and medical devices in the UK by ensuring they work and are acceptably safe. All our work is underpinned by robust and fact-based judgements to ensure that the benefits justify any risks.
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The MHRA is an executive agency of the Department of Health and Social Care.
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For mediaenquiries, please contact thenewscentre@mhra.gov.uk, or call on020 3080 7651.
Disclaimer: Curated by HT Syndication.
