Published Paper Details:

The ability of the body's systems to process and respond to prescription medications is influenced greatly by the presence of bacteria in the gastrointestinal tract. Gut bacteria have both directly or indirectly an effect on how a person metabolizes medications; they alter the effectiveness and safety of any given medication. In some cases the gut bacteria are necessary to activate certain medications. For example, prodrugs that contain the azo group are metabolized by the presence of bacteria to their active form sulfanilamide. In addition to activating some drugs, the gut flora are also responsible for many other types of biochemical changes to drugs, including acetylation, deacylation, decarboxylation, dehydroxylation, demethylation, and dehalonation. The gut flora also undergo conjugate hydrolysis, which is associated with many forms of drug-induced toxicity. Furthermore, gut flora have indirect effects upon drug metabolism and thereby influence how and where drugs are distributed, eliminated, and/or metabolized by their hosts by producing metabolites that compete with the prescribed medications for the same pathways. Additionally, there are reciprocal relationships between the gut microorganism and medications that can alter the composition of the gut flora and overall health of the gut. These relationships illustrate the interconnectedness of human biology with these small living things.