The impact of probiotics on antibiotic resistance: mechanisms, food safety risks, and regulatory considerations

Probiotics have gained a great attention due to their potential health benefits and are extensively used in food and medical sectors, including dairy food products, dietary supplements, and medicines. These beneficial microorganisms support gut health by enhancing mucosal integrity, promoting nutrient absorption, and balancing the gut microbiota. However, the misuse and overuse of antibiotics have led to the development of antibiotic resistance in gut microflora as repeated selective pressures lead to the development of resistant strains. Probiotics, when exposed to antibiotics, can acquire antibiotic resistance, which may contribute to the intra- and inter-species dissemination of antibiotic resistance genes (ARGs). This transfer of ARGs to the pathogens indicates a significant threat, potentially resulting in therapeutic failures and raising important safety concerns. Although probiotics provide various health benefits, their use requires careful control to prevent the spread of antibiotic resistance. This review discusses the potential risks associated with probiotics, focusing on the impact of antibiotic resistance and the importance of evaluating probiotics for their safety to protect public health.