Luminal antibiotic residues in the colon

Luminal antibiotic residues in the colon refer to the fraction of administered antibiotics that reach the large intestine, either due to incomplete absorption in the upper gastrointestinal tract or through biliary excretion (Kokai-Kun et al., 2017). These residues are not therapeutically necessary for treating systemic infections but exert unintended antimicrobial pressure on the commensal gut microbiota, leading to a state of dysbiosis (de Gunzburg et al., 2018). This disruption of the microbial ecosystem is a primary risk factor for the overgrowth of opportunistic pathogens, most notably Clostridioides difficile, and contributes to the selection and dissemination of antibiotic resistance genes (Connelly et al., 2019). Therapeutic strategies targeting these residues involve the use of microbiome-protecting agents, such as orally administered, non-absorbable enzymes like ribaxamase that degrade beta-lactams or adsorbents like DAV132 that sequester various antibiotic classes within the intestinal lumen. By neutralizing these residues before they can affect the colonic flora, these therapies aim to prevent antibiotic-associated diarrhea and secondary infections without interfering with the systemic efficacy of the primary antibiotic treatment.

Other names

Residual antibiotics in the gutFecal antibiotic residuesColonic antibiotic residuesIntestinal antibiotic residues

Enzymatic degradation or physical sequestration (adsorption) of antibiotic molecules within the gastrointestinal lumen to prevent disruption of the gut microbiota.