Antibiotics as modulators of the intestinal microbiota: between good and evil

In some countries of the world, the prevalence of obesity is increasing at the rate of an epidemic. A significant role in the staying healthy, strengthening immunity and normalizing metabolism is assigned to microbes. Among the drugs that are used to treat serious infectious diseases, antibiotics dominate as the drugs that keep on saving precious human lives. The side effects of antibiotic therapy on the intestinal microflora range from self-leveling and fast-passing “functional” diarrhea to life-threatening pseudomembranous colitis. Recently conducted epidemiological studies have shown that antibiotics are associated with a high risk of weight gain and the development of obesity. Violation of the intestinal microflora is caused not only by antibiotic therapy, but also by the intake of a number of products. Antibacterial drugs are widely used in agriculture as growth promoters, they are stored in the meat of animals and poultry that we eat. Obesity has been proven to be associated with a dysbiotic shift in the fecal microbiota and a low content of bifidobacteria. The hypothesis according to which the intestinal microbiota is a potentially variable target for the prevention and/or treatment of obesity is described in detail. Probiotics are agents capable of modulating and improving the intestinal microflora during antibiotic therapy. The review presents data demonstrating the ability of probiotics not only to prevent the development of dysbiosis that occurs when using antibiotics, but also to impede the emergence of overweight and obesity.