Hi Helen - This paper was sponsored by the pharmaceutical company trying to decide whether to develop a drug for treating antibiotic effects on the gut biome.

I read the paper and concluded that the drugs under study are not on the market for treating antibiotic changes in the gut - they are under development, still in the lab/animal testing stage.

I found references to three drugs that were tried for this report, but each has its own side effects. Benzbromarone is used for gout, but it has the side effect of liver toxicity. Dicumarol is an anticoagulant - again with its own issues. Tolfenamic acid, sometimes used for migraines or arthritis, can be toxic to kidneys,

Here is their summary:
"Altogether, we provide a route for identifying antidotes that specifically mitigate the collateral damage of antibiotics on commensals, particularly on Bacteroides spp. This concept needs further development before any application — e.g. antidotes should be tested for dosing or formulation to optimize pharmacokinetics and minimize adverse effects from their primary action. Currently, benzbromarone and dicumarol reach high enough colon concentrations when taken in normal doses2. Dietary compounds may also bear antidote potential.

In summary, this study provides a high-resolution map of the direct effect of antibiotics on human gut bacteria (Suppl. Table 1) down to the level of individual drugs, species and some selected strains. Since not designed to establish translational relevance, future work will be needed to assess the generalizability of these findings, given the intraspecies variation among bacteria. Nevertheless, our results challenge the traditional view that antibiotics are bona fide bacteriostatic or bactericidal, as this hard division breaks in non-model bacteria. Antibiotics that preferentially kill some species may be most detrimental to our gut microbiota, although the first studies in limited numbers of healthy individuals point to the gut microbiota having some resilience against specific antibiotic regimens32. Understanding the underlying mechanisms for this selective killing might open up ways for the development of new antimicrobials and strategies for controlled microbiome modulation33. Overall, interactions of antibiotics and commensals merit deeper exploration, and we anticipate future studies on the variation of antibiotic susceptibility within individual gut microbiomes and its relation to drug use, as well as on the specific antibiotic mode(s) of action and resistance in gut commensals."

So at this point, ability to nullify the effects of antibiotics on the gut with other medications are still theoretical.

We each need to decide if the need to knock out MAC or Pseudomonas outweighs the side effects of the medications.

I took meds for over 18 months in 2018 & 2019, managed the side effects, and with reasonable precautions I have remained infection free for 4 1/2 years. I would do it again.

Sue