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Dysbiosis
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===Antibiotic use === Antibiotics negatively alter the healthy combination of phyla within the gut microbiota, e.g. by reducing the ratio of [[Firmicutes]] to [[Bacteroidetes]], and increasing levels of [[Proteobacteria]].<ref name="Khan2019">{{Cite journal | title = Association of gut dysbiosis with intestinal metabolites in response to antibiotic treatment | date = 2019-03-01| url = https://www.sciencedirect.com/science/article/pii/S2452231718300265|journal=Human Microbiome Journal|volume=11 | pages = 100054 | last = Khan | first = Tariq Jamal | last2 = Hasan | first2 = Mohammed Nihal | last3 = Azhar | first3 = Esam I. | last4 = Yasir | first4 = Muhammad|language=en|doi=10.1016/j.humic.2018.11.004|issn=2452-2317}}</ref> The antibiotics [[ciprofloxacin]], [[vancomycin]], [[ampicillin]], [[cefazolin]] and [[cefoperazone]] reduce the diversity of gut microbiota, although in one study [[ciprofloxacin]] increased rather than decreased the Firmicutes to Bacteroidetes ratio.<ref name="Khan2019" /> Combination antibiotics cause more severe dysbiosis than using a single antibiotic.<ref name="Khan2019" /> Lifetime antibiotic use alters the gut microbiome and is a proposed risk factor for ME/CFS.<ref name="Konig2022" />
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