The influence of ceftriaxone, ceftazidime-avibactam, and piperacillin-tazobactam on the gut microbiota

Purpose The administration of antibiotics can induce dysbiosis of the gut microbiota, leading to diseases, e.g., irritable bowel syndrome, metabolic syndrome, and Clostridium difficile infection. However, the specific effects of different β-lactam antibiotics on the dysbiosis of the gut microbiota remain poorly understood, particularly in human studies. Methods This study assessed the impacts of ceftriaxone, ceftazidime-avibactam, and piperacillin-tazobactam on the diversity, composition, and bacterial interactions within the gut microbiota at days 1, 6, and 37 after administration. Results All three antibiotics significantly altered beta diversity of the gut microbiota by day 6, with ceftriaxone showing the most prolonged effects. Changes in the composition of the gut microbiota were more similar between the ceftazidime-avibactam and piperacillin-tazobactam groups and differed markedly from those in the ceftriaxone group. Consistent with beta diversity changes, bacterial interaction networks showed greater and longer-lasting disruptions of bacterial interaction in the gut microbiota in the ceftriaxone group compared to the ceftazidime-avibactam and piperacillin-tazobactam groups. Conclusion These findings highlight distinct patterns of microbiota disruption following ceftriaxone, ceftazidime-avibactam, and piperacillin-tazobactam treatments and provide insights for mitigating dysbiosis of the gut microbiota during β-lactam therapy.