Abstract

CEFTRIAXONE OVERUSE AND THE MICROBIOME: IMPACT ON GUT HEALTH AND LONG-TERM PATIENT OUTCOMES

*Ayushi Rai, Mudasir Manzoor, Dr. Amritpal Singh, Dr. Keshav Jindal, Dr. Sageer Ahmad

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Abstract

Ceftriaxone is a third-generation, broad-spectrum, widely used cephalosporin drug, which is still considered the choice drug in the management of severe bacterial infections because of its remarkable pharmacokinetic properties and biliary excretion. Yet, there is a large body of developing evidence suggesting its nonintentional effects on the intestinal microbiome. Here, the review will address in detail how ceftriaxone interferes with the intestinal microbiome and results in loss of microbial diversity, proliferation of opportunistic pathogens, and inability to produce beneficial metabolites like short-chain fatty acids. The review talks of clinical implications such as the augmented vulnerability to Clostridioides difficile infection, bloodstream infections, metabolic disturbance, degraded vaccine reactions, and potential developmental sequelae after infancy exposure. It also addresses the duration of antimicrobial resistance genes and not the full restoration of the gut ecosystem, particularly in vulnerable groups such as neonates, the elderly, and patients in the immunocompromised stage. Lastly, recent and recent advances in preventing ceftriaxone-associated dysbiosis (including probiotics, prebiotics, diet, faecal microbiota transplantation and sustained bacteriotherapy, and microbiome-guided drug use) are appraised. The awareness of these effects is important in the rational use of antibiotics and protecting the integrity of the human microbiome to secure improved patient outcomes.

Keywords: Ceftriaxone; gut microbiota; dysbiosis; Clostridioides difficile infection; antimicrobial resistance; short-chain fatty acids; microbiome recovery; probiotics; early-life exposure; antibiotic stewardship.