Table 1.

Summary of key concepts in modulation of the gut microbiota in infection prevention and control and antimicrobial stewardship

Domain	Key concepts	Key references
Antimicrobial Stewardship	Broad-spectrum antibiotics can cause significant alteration to the gut microbiota diversity, in particular those with anti-anaerobic activity	[8, 11]
	Alterations to the gut microbiota by antibiotics take months to years to restore	[24, 25]
	Shorter duration of antibiotic is equally effective than prolonged use and can reduce alterations to the gut microbiota	[26–28]
	Oral antibiotics and intravenously administered antibiotics that undergo enterohepatic re-circulation and excretion into bile have a greater impact on the gut microbiota compared to intravenous antibiotics alone	[30–33]
Infection Prevention and Control	Fecal microbiota transplant has been found to be one of the most effective ways to regulate the gut microbiota dysbiosis in the setting of CDI	[49]
	Fecal microbiota transplant has been studied in gut decolonization of MDRO, but has not conclusively been found to be effective	[55, 56, 58]
	Selective oral decontamination and selective digestive decontamination with oral antibiotics has been evaluated as a means of reducing infections caused by endogenous MDRO, but has not been found to be efficacious	[61–63]
	Restoration of the gut microbiota diversity through probiotics and prebiotics have some role in restoring gut diversity in specific diseases, such as necrotizing enterocolitis, acute infectious diarrhea and antibiotic-associated diarrhea	[64–69]