Effects of early-life antibiotics on the developing infant gut microbiome and resistome: a randomized trial.

Summary

Randomised trial in 147 term or near-term infants treated with broad-spectrum intravenous antibiotics for suspected early-onset neonatal sepsis in the first week of life, comparing three common empirical combinations against untreated healthy controls. Gut microbiota and antimicrobial resistance gene profiles were profiled from rectal swabs and faeces before and after treatment and up to 12 months. Antibiotics caused marked short-term shifts in microbial composition and resistance genes, with reduced Bifidobacterium and increased Klebsiella and Enterococcus, largely normalising by 12 months. The magnitude of ecological disruption differed by regimen, suggesting the choice of empirical antibiotics matters for collateral effects.

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