Antibiotic Induced Gut Dysbiosis: Prevention and Management

Background: Antibiotics are indispensable in the treatment of bacterial infections, but their effects extend beyond the targeted pathogen. By altering the composition and metabolic activity of the intestinal microbiota, antibiotic exposure can disrupt the ecological balance of the gut, a phenomenon known as antibiotic-induced gut dysbiosis. Although some changes are temporary, others may persist after treatment and contribute to gastrointestinal complications, including Clostridioides difficile infection. Objective: This review examines the mechanisms underlying antibiotic-induced gut dysbiosis, its clinical consequences, and current and emerging approaches to prevention and management. Methods: A narrative review approach is proposed, drawing on peer-reviewed literature, clinical trials, and professional guidelines concerning intestinal microbiota, antibiotic-associated complications, probiotics, dietary interventions, antimicrobial stewardship, and microbiota-based therapies. Before submission, the search strategy and all references should be verified and updated through a reproducible database search. Results: Antibiotics can reduce microbial diversity, disturb colonisation resistance, alter intestinal metabolic pathways, and facilitate the expansion of opportunistic microorganisms. The extent of disruption varies according to the antibiotic, duration of exposure, host characteristics, and baseline microbial composition. Prevention primarily depends on appropriate antibiotic prescribing, the shortest effective treatment duration, and infection-control practices. Dietary measures may support recovery, while probiotics have strain-specific and indication-dependent evidence. Faecal microbiota transplantation and approved microbiota-based products have established roles in selected patients with recurrent C. difficile infection, but their use for general microbiome restoration remains insufficiently supported. Conclusion: Antibiotic-induced gut dysbiosis should be considered an important consequence of antimicrobial exposure rather than an incidental gastrointestinal disturbance. A combination of antimicrobial stewardship, individual risk assessment, nutritional support, and evidence-based management of complications offers the most clinically defensible approach. Further research is needed to identify patients at greatest risk and develop personalised strategies for microbiome recovery.