Gut Microbiota-Mediated Drug Metabolism: Impact on Pharmacokinetics and Personalized Therapeutics

The gut microbiota plays an important role in drug metabolism and pharmacokinetics by influencing drug absorption, bioavailability, and toxicity through various microbial enzymatic reactions.[1–3]. Increasing evidence suggests that microbiota-mediated drug metabolism contributes significantly to interindividual variability in therapeutic response and adverse drug reactions.[4,5] Gut microorganisms can activate prodrugs, inactivate therapeutic agents, generate toxic metabolites, and regulate host metabolic enzymes.[6,7] Advances in pharmacomicrobiomics and microbiome research have highlighted the importance of integrating microbial profiling into personalized medicine.[8,9] Understanding drug–microbiota interactions may improve therapeutic outcomes, minimize adverse effects, and facilitate precision-based pharmacotherapy.[10]