TABLE 4

Outstanding questions in pharmacomicrobiomics

Key Questions
Do disease-associated microbiomes impact on bacterial enzyme expression and/or activity to dysregulate xenobiotic metabolism?
What is the impact of extreme of life microbiome variation on pharmacokinetics and pharmacodynamics?
Can we unravel disease vs. drug-induced contributions to microbiome alterations?
Can the use of microbiome composition to predict therapeutic response be incorporated into clinical practice?
Can we identify bacteria- and/or enzyme-specific host–microbe interactions for subsequent therapeutic targeting?
Can we compile and systematically evaluate currently unexplained aberrant pharmacokinetic observations?
Can diet be used to beneficially tune microbial xenobiotic metabolism?
Can we differentiate between effects of acute and long-term exposure to xenobiotics on the gut microbiome?
Should we re-evaluate the guidelines for coadministration of antibiotics?