AI Article Synopsis
- Researchers examined the effects of a new antibiotic, gepotidacin, on the microbiome in a Phase 2a clinical trial involving 22 adult women with uncomplicated urinary tract infections.
- Microbiome samples were taken at three points: before treatment, after treatment, and a month later, showing significant temporary changes in microbiome diversity after five days, particularly in the gastrointestinal tract.
- By the follow-up visit, microbiome diversity reverted to pre-treatment levels, indicating that gepotidacin's impact on the microbiome is short-lived; the study suggests future drug trials should further explore microbiome changes and recovery.
Article Abstract
Background: With increasing concerns about the impact of frequent antibiotic usage on the human microbiome, it is important to characterize the potential for such effects in early antibiotic drug development clinical trials. In a randomised Phase 2a clinical trial study that evaluated the pharmacokinetics of repeated oral doses of gepotidacin, a first-in-chemical-class triazaacenaphthylene antibiotic with a distinct mechanism of action, in adult females with uncomplicated urinary tract infections for gepotidacin (GSK2140944) we evaluated the potential changes in microbiome composition across multiple time points and body-sites ( ClinicalTrials.gov : NCT03568942).
Results: Samples of gastrointestinal tract (GIT), pharyngeal cavity and vaginal microbiota were collected with consent from 22 patients at three time points relative to the gepotidacin dosing regimen; Day 1 (pre-dose), Day 5 (end of dosing) and Follow-up (Day 28 ± 3 days). Microbiota composition was determined by DNA sequencing of 16S rRNA gene variable region 4 amplicons. By Day 5, significant changes were observed in the microbiome diversity relative to pre-dose across the tested body-sites. However, by the Follow-up visit, microbiome diversity changes were reverted to compositions comparable to Day 1. The greatest range of microbiome changes by body-site were GIT followed by the pharyngeal cavity then vagina. In Follow-up visit samples we found no statistically significant occurrences of pathogenic taxa.
Conclusion: Our findings suggest that gepotidacin alteration of the human microbiome after 5 days of dosing is temporary and rebound to pre-dosing states is evident within the first month post-treatment. We recommend that future antibiotic drug trials include similar exploratory investigations into the duration and context of microbiome modification and recovery.
Trial Registration: NCT03568942 . Registered 26 June 2018.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8207760 | PMC |
| http://dx.doi.org/10.1186/s12866-021-02245-8 | DOI Listing |
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