Figure 1. Mechanisms for drug-microbiota interactions. There are several known mechanisms for drug-microbiota interaction that may affect treatment outcomes. Of course, it is not always the case that there will be interactions. For example, some drugs may bypass the intestinal microbiota altogether (e). However, others will be enzymatically activated (b) or inactivated (a) by certain microbes or be converted into potentially toxic substances (f). More recently, the composition of the microbiota has been linked to treatment outcomes, either in association with taking a drug (c) or in response to the existence of certain microbes prior to its use (d). ICI = immune checkpoint inhibitor; SCFA = short chain fatty acid.
