The Gut Microbiota’s Role in Drug Absorption, Metabolism and Efficacy: Implications for Personalized Medicine

Advances in microbiome profiling technologies enable the assessment of individual gut microbiota composition, paving the way for personalized drug therapy. Tailoring medications based on a patient’s microbiome could enhance efficacy and minimize side effects. Pharmacogenomics, combined with microbiome analysis, could lead to more accurate predictions of drug responses and optimized treatment plans. In this review, we explore the relationship between drug metabolism and efficacy and the gut microbiome, with a specific focus on enzymatic processes of how gut bacteria metabolize drugs, drugs affected by gut microbiota, and drugs associated with dysbiosis and resulting complications. A comprehensive literature search was performed using PubMed and Google Scholar databases. Articles published between 2013 and 2024 were prioritized to ensure up-to-date findings. The gut microbiota significantly impacts drug absorption by altering drug solubility and permeability through microbial metabolism, modulation of the intestinal barrier, and interactions with transport proteins. Furthermore, medications can significantly impact gut microbiota, leading to dysbiosis and various complications. More studies are needed to elucidate the specific mechanisms through which gut microbiota influences drug action.