Background: The natural complex of microorganisms that inhabit the digestive system is estimated to be trillions of bacteria and is known as the gut microbiota. It is now being appreciated more for its involvement in metabolism of drugs, and effects exerted on efficacy and toxicity of drugs. Differences in the composition of the microbiota in the gut cause differences in drug response among people, and therapeutic processes.Objectives: To evaluate the modulation of gut microbiota on drug metabolism and outcome, and analyze the therapeutic outcomes influenced by the microbiome, and to also identify microbial indicators predictive of variable therapeutic outcomes.Study Design: A Cross-Sectional Study.Place and Duration of the Study: Department of Biochemistry, Saidu Medical College, Swat KP – Pakistan from January 2022 to January 2023.Methodology: The current study recruited a sample of 150 patients. The bacterial structure in the gut was investigated using 16S rRNA analysis, and drug metabolism was determined through the blood plasma samples taken at the required time points. Patients were categorized according to their drug efficacy performance, and statistical comparisons were made to evaluate the relationships, accompanied by standard deviations and p-values, respectively, for proper testing of the results’ significanceResults: Among the 150 patients, a higher number of bacterial strains was also associated with better drug outcomes in terms of SD (.35, p < 0.05). The comparison of the rates of metabolism of the drugs between both groups revealed a group difference (SD = 0.28, p = 0.01). They found that those patients who had longer and more complex bacterial signatures had better outcomes from their treatment than patient with less diverse levels of bacteria in their gut.Conclusion: The buy-in of the study is that a direct association between the gut microbiota profile and Drug metabolism efficiency and effectiveness exists. It may also help in identifying biomarkers of microbial origin that may help to improve treatment outcomes, improve compliance with individual treatment plans, and reduce side effects.
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