[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-435596-105":3,"detail-sidebar-cat-0-en-105":81,"doc-detail-435596-en":131},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","microbiome-selective-dna-pol-iiic-inhibitors-in-oncology-infection-management-letter-to-the-editor","Microbiome-selective DNA Pol IIIC inhibitors in oncology infection management - Letter to the Editor","","Oncology patients face high bacterial infection risk driven by chemotherapy-associated mucosal injury and immunosuppression, with infectious complications occurring in up to 60% of cases and 20–30% of hematopoietic transplant recipients requiring hospitalization. Broad-spectrum antibiotics can cause gut microbiome dysbiosis linked to recurrent infection and diminished immune checkpoint inhibitor effectiveness. Meta-analyses associate antibiotic exposure around ICI start with 30–50% lower overall survival and 25–40% reduced progression-free survival. DNA polymerase IIIC inhibitor–based antibiotics, including ibezapolstat, show 88–96% cure rates in C. difficile while preserving microbial diversity and limiting antimicrobial-resistant expansion, suggesting a class-wide, microbiome-sparing strategy to maintain immune function and support anticancer treatment.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/microbiome-selective-dna-pol-iiic-inhibitors-in-oncology-infection-management-letter-to-the-editor/435596/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/microbiome-selective-dna-pol-iiic-inhibitors-in-oncology-infection-management-letter-to-the-editor/435596.png","ImageObject",300,407,{"name":42,"@type":43},"RuangKosong","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-11-01","2026-09-29",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",15,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"Why are oncology patients at high risk for bacterial infections?","Question",{"text":63,"@type":64},"Chemotherapy-associated mucosal barrier injury and immunosuppression increase susceptibility. Up to 60% of patients receiving cytotoxic chemotherapy develop infection-related complications.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"How does broad-spectrum antibiotic use affect immune checkpoint inhibitor outcomes?",{"text":68,"@type":64},"Antibiotic exposure near ICI initiation is associated with reduced overall survival and progression-free survival. Loss of microbial diversity and depletion of commensal taxa are linked to these effects.",{"name":70,"@type":61,"acceptedAnswer":71},"What evidence supports DNA polymerase IIIC inhibitors as microbiome-sparing therapies?",{"text":72,"@type":64},"DNA polymerase IIIC inhibitor antibiotics, including ibezapolstat, have shown high cure rates in C. difficile infection while preserving gut microbial diversity and reducing expansion of antimicrobial-resistant organisms. Conference data suggest class-wide microbiome-sparing effects.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},435596,1790724689,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,120,123,127],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":113,"slug":114},8,"Research & Report",30,"research-report",{"id":116,"doc_module":4,"doc_module_name":25,"category_name":117,"show_sort_weight":118,"slug":119},9,"Religion & Spirituality",20,"religion-spirituality",{"id":118,"doc_module":4,"doc_module_name":25,"category_name":121,"show_sort_weight":118,"slug":122},"World Cup","world-cup",{"id":124,"doc_module":4,"doc_module_name":25,"category_name":125,"show_sort_weight":124,"slug":126},10,"Lifestyle","lifestyle",{"id":128,"doc_module":4,"doc_module_name":25,"category_name":129,"show_sort_weight":97,"slug":130},19,"General","general",{"code":4,"msg":82,"data":132},{"doc_id":79,"user_id":133,"nickname":42,"user_avatar":134,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":26,"language":140,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":12,"update_tm":144,"read_time":97,"preview_page_count":4},962090883219,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","Letter to the Editor  \nMicrobiome-selective DNA Pol IIIC inhibitors in oncology infection management  \nMuhammad Shahid Mehmood, MPhila , Maryam Abid, FESMOb , Naseeb Danaf, MDc ,*  \nAbstract  \nOncology patients experience high rates of bacterial infection due to chemotherapy-associated mucosal injury and immunosuppression, with up to 60% developing infectious complications and 20–30% of hematopoietic transplant recipients requiring hospitalization. Broad-spectrum antibiotics, although essential, frequently induce gut microbiome dysbiosis, which is associated with recurrent infection and reduced immune checkpoint inhibitor (ICI) effectiveness. Meta-analyses indicate that antibiotic exposure near ICI initiation leads to a 30–50% decrease in overall survival and a 25–40% reduction in progression-free survival. DNA polymerase IIIC inhibitor antibiotics, including ibezapolstat, have demonstrated 88–96% clinical cure rates in Clostridioides difficile infection while preserving gut microbial diversity and limiting expansion of antimicrobial-resistant organisms. Recent conference data suggest these microbiome-sparing effects may be class-wide. This targeted antimicrobial mechanism offers a potential strategy to maintain immune function, reduce recurrent infection, and support anticancer treatment response in immunocompromised patients.  \nKeywords: antimicrobial resistance, DNA polymerase IIIC inhibitors, immune checkpoint inhibitors, microbiome preservation, oncology infection management  \nTo the Editor,  \nOncology patients experience high rates of bacterial infection due to immunosuppression, mucosal barrier injury, and repeated antimicrobial exposure. Up to 60% of patients receiving cytotoxic chemotherapy develop infection-related complications, and 20–30% of hematopoietic stem cell transplant recipients require hospitalization for severe bacterial infections[1] . Broad-spectrum antibiotics remain central to management but are increasingly recognized to drive gut microbiome dysbiosis, which correlates with infection recurrence, poor treatment tolerance, and reduced antitumor immune activity[2] .  \nMeta-analyses demonstrate that antibiotic exposure within 60 days before or after initiating immune checkpoint inhibitors (ICIs) is associated with a 30–50% reduction in overall survival, 25–40% reduction in progression-free survival, and higher rates of  \naFaculty of Veterinary Science, Institute of Microbiology, University of Agriculture Faisalabad, Faisalabad, Pakistan, bDepartment of Oncology and Radiotherapy, King Edward Medical University, Lahore, Pakistan and cFaculty of Medical Sciences, Lebanese University, Beirut, Lebanon  \nSponsorships or competing interests that may be relevant to content are disclosed at the end of this article.  \n*Corresponding author. Address: Faculty of Medical Sciences, Lebanese University, P.O. Box 6573/14, Beirut, Lebanon. Tel.: +96 171 164 810.  \n[E-mail: naseeb.danaf@st.ul.edu.lb](E-mail: naseeb.danaf@st.ul.edu.lb) (N. Danaf).  \nCopyright © 2025 The Author(s). Published by Wolters Kluwer Health, Inc. This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.  \nAnnals of Medicine & Surgery (2026) 88:1070–1071  \nReceived 9 November 2025; Accepted 13 November 2025  \nPublished online 3 December 2025  \n[http://dx.doi.org/10.1097/MS9.0000000000004423](http://dx.doi.org/10.1097/MS9.0000000000004423)  \nearly disease progression, across melanoma, lung cancer, and renal cell carcinoma cohorts[3]. These effects are strongly linked to loss of microbial diversity and depletion of commensal taxa involved in T-cell priming and mucosal immune signaling[4].  \nDNA polymerase IIIC (Pol IIIC) inhibitor antibiotics represent an emerging solution to this ","cbCaiexPLDtVQlIN","https://ap.wps.com/l/cbCaiexPLDtVQlIN","pdf",171712,"English","# Abstract\n# To the Editor\n## Background and clinical rationale\n## Evidence linking antibiotics and ICI outcomes\n## Mechanism and emerging IDWeek 2025 data\n## Relevance to oncology and immune response\n## Transparency, ethics, funding, and disclosures","[{\"question\":\"Why are oncology patients at high risk for bacterial infections?\",\"answer\":\"Chemotherapy-associated mucosal barrier injury and immunosuppression increase susceptibility. Up to 60% of patients receiving cytotoxic chemotherapy develop infection-related complications.\"},{\"question\":\"How does broad-spectrum antibiotic use affect immune checkpoint inhibitor outcomes?\",\"answer\":\"Antibiotic exposure near ICI initiation is associated with reduced overall survival and progression-free survival. Loss of microbial diversity and depletion of commensal taxa are linked to these effects.\"},{\"question\":\"What evidence supports DNA polymerase IIIC inhibitors as microbiome-sparing therapies?\",\"answer\":\"DNA polymerase IIIC inhibitor antibiotics, including ibezapolstat, have shown high cure rates in C. difficile infection while preserving gut microbial diversity and reducing expansion of antimicrobial-resistant organisms. Conference data suggest class-wide microbiome-sparing effects.\"}]","Microbiome-selective DNA Pol IIIC inhibitors in oncology infection management - Letter to the Editor | PDF",1790674354]