Antibiotic overuse is becoming a severe public health concern worldwide because overuse causes bacterial changes that might lead to antimicrobial resistance. Additionally, the overuse of antibiotics can alter the stability of human microbial communities, thus risking human health. In this study, skin samples from 14 healthy volunteers who received different types of commonly used systemic antibiotics were collected at multiple time points for a year to analyze the microbial composition of the skin. This study demonstrated that systemic administration of antibiotics resulted in significant changes in skin microbial communities and expansion of antibiotic resistant bacteria. The findings of this study provided firsthand evidence of the lasting effects of systemic antibiotic treatment on the skin microbiome.

What is exciting about this article?

This study is the first to provide direct evidence of the damage to the human skin microbiome with oral antibiotic usage. It demonstrates that standard oral antibiotic treatment can result in long-lasting changes in the human skin bacterial population. These results underscore the need for alternatives to current antibiotic prescription practices. 

How does this fit into the larger NIAMS portfolio?

The microbiome is an essential component of the human skin and maintains relatively stable communities in healthy individuals. However, overuse of oral antibiotics, which causes a change in the bacterial diversity in the skin, is common in the United States. The findings of this study will raise awareness of the importance of limiting antibiotic usage and will provide support for clinical advice to prevent the overuse of antibiotics.

Grant support


Research Areas:

Computational Biology Genetics and Genomics Microbiology and Infectious Diseases Skin Biology


Alterations of human skin microbiome and expansion of antimicrobial resistance after systemic antibiotics.

Jo JH, Harkins CP, Schwardt NH, Portillo JA, NISC Comparative Sequencing Program, Zimmerman MD, Carter CL, Hossen MA, Peer CJ, Polley EC, Dartois V, Figg WD, Moutsopoulos NM, Segre JA, Kong HH
Sci Transl Med.
2021 Dec 22;
doi: 10.1126/scitranslmed.abd8077
PMID: 34936382

Research reported in this publication was supported by the Intramural Research Program of the NIHʼs National Institute of Arthritis and Musculoskeletal and Skin Diseases.