Antibiotic-associated gut dysbiosis and intestinal failure in critically ill patients: Mechanisms and interventions

Figure 1 PRISMA 2020 flow diagram - literature search and selection. PRISMA 2020 flow diagram summarizing the literature search and study selection process. Five databases (PubMed, Web of Science, EMBASE, CNKI, Wanfang) were searched from inception to December 31, 2025. Records identified: n = 3214. After removal of duplicates (n = 843), 2371 records were screened by title and abstract. Of these, 2218 were excluded as irrelevant. Full-text assessment was performed for 153 records; 113 were excluded for the following reasons: Not addressing antibiotic-related dysbiosis or intestinal failure mechanisms (n = 48), insufficient methodological quality (n = 31), conference abstracts or inaccessible full text (n = 22), case reports (n = 12). Forty studies were ultimately included in this narrative review.