Antibiotic-induced disruption of lipid mediator signaling: Implications for cardiovascular inflammation and cardiotoxicity.

Antibiotics remain the cornerstone of treatment for infectious disease, yet a growing body of evidence shows that these drugs also disrupt host inflammatory and metabolic pathways well beyond their intended antimicrobial target. One consequence that has received comparatively little attention is their effect on lipid mediator signaling. Polyunsaturated fatty acids serve as precursors to lipid mediators that keep the vasculature in balance by governing both inflammatory and resolving pathways. Antibiotic exposure disturbs this balance in two connected ways, by driving gut microbiota dysbiosis and by directly impairing mitochondrial function and raising oxidative stress. Together these changes tilt lipid mediator profiles toward pro-inflammatory eicosanoids at the expense of pro-resolving mediators, promoting endothelial dysfunction, atherosclerosis progression, and myocardial injury. This review brings together the laboratory and clinical evidence linking antibiotic use to lipid mediator disturbances and cardiovascular risk, and considers strategies that may help preserve lipid mediator balance during antibiotic therapy.