Protection of the Human Gut Microbiome From Antibiotics

J Infect Dis. 2018 Jan 30;217(4):628-636. doi: 10.1093/infdis/jix604.


Background: Antibiotics are life-saving drugs but severely affect the gut microbiome with short-term consequences including diarrhea and selection of antibiotic-resistant bacteria. Long-term links to allergy and obesity are also suggested. We devised a product, DAV132, and previously showed its ability to deliver a powerful adsorbent, activated charcoal, in the late ileum of human volunteers.

Methods: We performed a randomized controlled trial in 28 human volunteers treated with a 5-day clinical regimen of the fluoroquinolone antibiotic moxifloxacin in 2 parallel groups, with or without DAV132 coadministration. Two control goups of 8 volunteers each receiving DAV132 alone, or a nonactive substitute, were added.

Results: The coadministration of DAV132 decreased free moxifloxacin fecal concentrations by 99%, while plasmatic levels were unaffected. Shotgun quantitative metagenomics showed that the richness and composition of the intestinal microbiota were largely preserved in subjects co-treated with DAV132 in addition to moxifloxacin. No adverse effect was observed. In addition, DAV132 efficiently adsorbed a wide range of clinically relevant antibiotics ex vivo.

Conclusions: DAV132 was highly effective to protect the gut microbiome of moxifloxacin-treated healthy volunteers and may constitute a clinical breakthrough by preventing adverse health consequences of a wide range of antibiotic treatments.

Clinical trials registration: NCT02176005.

Keywords: Clostridium difficile; antibiotics; fluoroquinolones; microbiome.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / administration & dosage*
  • Anti-Bacterial Agents / analysis
  • Charcoal / administration & dosage*
  • Feces / chemistry
  • Feces / microbiology
  • Female
  • Gastrointestinal Microbiome / drug effects*
  • Healthy Volunteers
  • Humans
  • Male
  • Metagenomics
  • Microbiota / drug effects*
  • Middle Aged
  • Moxifloxacin / administration & dosage*
  • Moxifloxacin / analysis
  • Treatment Outcome
  • Young Adult


  • Anti-Bacterial Agents
  • Charcoal
  • Moxifloxacin

Associated data