Impact of prolonged amoxicillin treatment in the gut microbiome and resistome in patients with low back pain and Modic changes

The collateral impact of antibiotics on the microbiome has attained increasing attention. However, the ecological consequences of long-term antibiotic exposure on the gut microbiome, including antibiotic resistance, are still limited. Here, we investigated long-term exposure effects to amoxicillin on the human gut microbiome and resistome. Fecal samples were collected from 20 patients receiving 3-month amoxicillin or placebo treatment as part of a Norwegian multicenter clinical trial on chronic low back pain (AIM study). Samples were collected at baseline, last day of treatment, and 9 months after antibiotic termination. The abundance and diversity of microbial and resistome composition were characterized using whole shotgun and functional metagenomic sequencing data.