Ivermectin and the Gut Microbiome

Table of Contents

1. Why the Gut Microbiome Matters for a Deworming Drug
2. What Ivermectin Does to Gut Bacteria in the Laboratory
3. Studies in Mice
4. Studies in Other Animals
5. Studies in People Treated for Worms
6. The Gut Microbiome and How Well Deworming Works
7. The Skin Microbiome and Rosacea
8. Beyond the Human Gut
9. What Is Not Yet Known
10. Key Research Papers
11. Connections
12. Featured Videos

Why the Gut Microbiome Matters for a Deworming Drug

A deworming medicine taken by mouth passes through the intestine, where the gut bacteria live alongside the worms the medicine is meant to kill. The gut microbiome matters for health in its own right. The authors of a 2019 study in Kenya summed it up this way: the microbiome is affected by what people eat, the medicines they take and the infections they acquire, and in turn it affects how nutrients are absorbed and whether the intestine becomes excessively inflamed [8].

The question also matters because of scale. Soil-transmitted helminths (worms spread through soil contaminated with human faeces, such as roundworm, whipworm and hookworm) infect 1.5 billion people worldwide, and treatment with deworming drugs is the key intervention [6]. Mass deworming programmes are a common public health strategy in high-risk, low-income countries [9]. The Kenyan study team wrote that without a complete understanding of what mass deworming does to the microbiome, it is impossible to accurately calculate the cost-effectiveness of these programmes or to guard against possible harmful side effects [8].

The drug may act on bacteria

A 2022 review was written after use of ivermectin increased during the COVID-19 pandemic, when the drug had been suggested against the virus that causes COVID-19. The review points out that ivermectin has antibacterial properties, so prolonged use may affect the commensal gut bacteria, the harmless bacteria that normally live in the gut. It examines the concern that treating people with COVID-19 could lead to dysbiosis, an imbalance in the gut microbiome [10].

The worms shape the gut bacteria too

The worms themselves also affect the gut bacteria, though studies disagree on how much. In two groups of people studied in the Philippines, 70.3% carried at least two kinds of parasite and 16% carried at least five. The more kinds of worm a person carried, especially soil-transmitted worms living in the gut, the higher the diversity of their gut bacteria. People infected only with Schistosoma japonicum, a blood fluke, showed no significant link. The authors note that a healthy gut is generally associated with high bacterial diversity, and suggest the worms may raise it by changing the immune system or the gut environment [11].

In Kenya, by contrast, neither the giant roundworm Ascaris lumbricoides nor the hookworm Necator americanus significantly changed the overall diversity of the gut bacteria compared with uninfected people of the same age. The authors note that studies in humans have reached varied conclusions, and that the effect appears to vary widely with the worm species [8]. The Gut Microbiome and Parasites page covers the worms’ side of the story in more depth.

Separating the drug from the worms

So when people are dewormed, a change in their gut bacteria can come from the worms leaving, from the drug acting on bacteria, or from both. In the Kenyan study, bacterial richness, an estimate of how many kinds of bacteria are present, fell after treatment with albendazole, another deworming drug, even in people who had no worms before treatment. The authors concluded that possible antimicrobial effects of the treatment itself have to be taken into account whenever gut bacteria are compared after deworming [8]. A 2023 laboratory study adds that, as far as its authors knew, earlier information on ivermectin and the gut bacteria had come only from people who were ill and were treated with ivermectin alone or with other medicines, so those results were shaped by the illness and the other treatments as well as by the drug [1].

What Ivermectin Does to Gut Bacteria in the Laboratory

Single strains of gut bacteria

In a 2024 laboratory study, researchers grew 59 bacterial isolates, single strains of gut bacteria, in the presence of ivermectin and of moxidectin, a related deworming drug. Because both drugs have a structure like that of the macrolide antibiotics, the researchers set out to map their antibiotic spectrum, the range of bacteria they act on, and their possible role in cross-resistance to macrolides and other families of antibiotics, in which bacteria that adapt to one drug also become harder to kill with others [2].

• The growth patterns of bacteria exposed to the two deworming drugs were comparable to those seen with a selection of the antibiotics tested [2].
• Five of the isolates were then exposed to the deworming drugs repeatedly. They became less sensitive to the deworming drugs and, to some extent, less sensitive to antibiotics. Sensitivity was measured both by how the bacteria grew and by the minimal inhibitory concentration, the lowest amount of a drug that stops a bacterium from growing [2].

The study’s title sums up the findings as “antibiotic-like phenotypes of growth inhibition and adaptation”: the drugs held back bacterial growth in the way antibiotics do, and the bacteria adapted to them. The authors concluded that the potential off-target effects of large-scale use of ivermectin and moxidectin, meaning effects on organisms other than the worms the drugs are given for, need careful monitoring [2].

A whole gut community from healthy donors

A 2023 study took a different approach. Instead of single strains, it used whole communities of gut bacteria grown from the stool of three healthy adults in a laboratory simulator of the human intestinal microbial ecosystem. The communities were grown on three versions of the feed: the standard medium, and the medium with either soluble or insoluble fiber added. The team identified the bacteria present by 16S gene sequencing, which reads a gene that every bacterium carries; counted the cells by flow cytometry; and measured the chemicals the bacteria produced by gas chromatography–mass spectrometry [1].

• Ivermectin caused “minor and temporary changes” to the communities, both in which bacteria were present and in the substances they produced [1].
• The donor’s starting community influenced how the bacteria responded to ivermectin [1].
• According to the authors, the soluble fiber in the feed could protect the gut bacteria from ivermectin [1].
• An increase in short-chain fatty acids, acids that gut bacteria make when they ferment fiber, was predicted by computer analysis and detected with ivermectin treatment [1].

The authors concluded that ivermectin “is not expected to induce dysbiosis or yield adverse effects if administered to healthy adults” [1]. This was a laboratory result with bacteria from three donors, not a study of people taking the drug.

The two laboratory approaches answer different questions: the first tested single strains one at a time, the second a whole community. Studies in people are described further down this page.

Studies in Mice

In a 2023 study, researchers set out to understand the effects of continuous ivermectin use on the gut bacteria. Genetically identical laboratory mice of the C57BL/6 strain were given either ivermectin or salt water (saline) by gavage, a tube passed into the stomach [3].

In the mice given ivermectin, the gut bacteria became imbalanced. Four phyla, the broadest groupings of bacteria, decreased: Bacteroidetes, Firmicutes, Proteobacteria and Tenericutes. One phylum, Verrucomicrobia, increased. The mice with this imbalance also showed contents of the caecum (a pouch at the start of the large intestine) that promoted inflammation and stimulated the immune system, disrupted organisation of the tissue of the caecum, and damage to the tissue of the liver [3].

Mice with and without the imbalance were then given a lung infection with Pseudomonas aeruginosa, a bacterium that can cause lung infections. The gut imbalance did not make the mice more susceptible to this infection in the short term: both groups had similar numbers of live bacteria recovered from their organs, similar tissue damage under the microscope and a similar pattern of immune signals (cytokines) in the lung. The liver was different. In the mice that received both ivermectin and the infection, the liver damage extended further, and the infection made it worse [3].

These are findings in mice; the study did not test people.

Studies in Other Animals

Chinchillas

Before a 2023 study, the clinical use of ivermectin in chinchillas had not been evaluated. Ten clinically healthy chinchillas (Chinchilla lanigera) were followed for 14 days, and all received the same ivermectin injection under the skin. Their droppings were sampled on day 0, before the injection, and on day 14, and the bacteria were identified by 16S gene sequencing [4].

No clinical abnormalities were seen after the injection. The amount and diversity of bacteria in the droppings did not change significantly, but some bacterial species changed places as the dominant ones. The authors concluded that ivermectin was associated with minimal changes in the droppings’ bacteria of healthy chinchillas, with no observed harm to their general health in the short term [4].

Australian sea lion pups

The Australian sea lion (Neophoca cinerea) is endangered, and its pups carry an endemic hookworm, Uncinaria sanguinis. In a 2022 study at Seal Bay on Kangaroo Island, pups were treated with ivermectin applied to the skin. The researchers compared the gut bacteria of 23 treated and 23 untreated pups in the 2019 and 2020/21 breeding seasons, sampling before and after treatment on up to four occasions over four to five months [5].

• In the 2020/21 season, the treated pups had higher richness and diversity of gut bacteria than the untreated pups (p = 0.008; a p-value this small means a difference this large would rarely arise by chance alone) [5].
• The individual pup explained most of the variation in the gut bacteria: 35% in 2019 and 42% in 2020/21 [5].
• There were no statistically significant differences in the make-up of the gut bacteria between treated and untreated pups in either season [5].

The authors concluded that ivermectin on the skin did not alter the composition of the pups’ gut bacteria, and that this supports its use as a safe, minimally invasive way to improve pup survival in this endangered species [5].

Wild Grant’s gazelles

A 2024 experiment in wild Grant’s gazelles (Nanger granti) points to an indirect route by which deworming can change the gut bacteria: through changes in the animal’s feeding behaviour. The abstract does not name the deworming drug that was used [12].

• In males, deworming shifted the diversity and structure of the gut bacteria within about 40 to 70 days. In females, effects on the structure emerged over a longer period, about 500 days [12].
• Deworming nearly doubled the time females spent feeding but did not change feeding time in males. The authors suggest the long-term effect in females was potentially due to this change in feeding behaviour [12].
• Deworming removed the link between gut bacterial diversity and diet in females, and treated females kept a more stable mix of bacteria [12].

The mouse, chinchilla and sea lion studies differ in species and in how the drug was given (by stomach tube, by injection and on the skin), so their results cannot be compared directly.

Studies in People Treated for Worms

In each of the three ivermectin studies below, the participants were infected with worms and ivermectin was given together with a second deworming drug, so its effects have to be read alongside those of its partner. Studies of albendazole given alone follow them.

Hookworm-infected adolescents, 2018

When this study was published, its authors noted that interactions between deworming drugs and the gut microbiota had not yet been studied. Adolescents infected with hookworm received one of four treatments: tribendimidine alone, tribendimidine plus ivermectin, tribendimidine plus oxantel pamoate, or albendazole plus oxantel pamoate. Tribendimidine and oxantel pamoate are also deworming drugs. Stool samples were collected from each adolescent before treatment, 24 hours after and 3 weeks after, 144 samples in all, and the bacteria were identified by 16S gene sequencing [6].

• The three treatments without ivermectin were not associated with any major change in which bacteria were present, either at 24 hours or at 3 weeks [6].
• Tribendimidine plus ivermectin was followed by a high abundance of the phylum Bacteroidetes at 24 hours, due mainly to two bacterial families, Prevotellaceae and Candidatus homeothermaceae. The change was transient and had disappeared three weeks after treatment [6].
• The higher abundance of Bacteroidetes predicted an increase in metabolic pathways (chains of chemical reactions) that the bacteria use to make B vitamins [6].

The authors describe “a strong relationship between tribendimidine and ivermectin administration and the gut microbiota”, and call for further studies of how these interactions work and of their possible effects on health [6].

Whipworm and hookworm in Laos, 2022

In a registered clinical trial at Pak-Khan, Laos, 80 people infected with whipworm (Trichuris trichiura) who also carried hookworm received either albendazole alone (41 people) or albendazole plus ivermectin (39 people). Stool samples taken before and after treatment were used both to check the treatment’s effect on the worms and to profile the gut bacteria with three genetic methods. The researchers identified three bacterial enterotypes, broad types of gut bacterial community [13]. How the enterotype related to the cure rate is described in the next section.

Whipworm in Côte d’Ivoire, 2026

Human whipworm infection, caused by Trichuris trichiura and Trichuris incognita, affects over 400 million people and responds poorly to the standard benzimidazole drugs, the family that includes albendazole. Ivermectin-albendazole and moxidectin-albendazole have emerged as promising combinations, but laboratory evidence suggested that ivermectin and moxidectin may also affect gut bacteria. A randomised controlled trial of 204 infected people in Côte d’Ivoire therefore looked at the off-target effects of the treatments on the gut microbiome. Participants received albendazole (400 mg), ivermectin-albendazole (ivermectin at 200 micrograms per kilogram of body weight, with 400 mg of albendazole) or moxidectin-albendazole (8 mg of moxidectin with 400 mg of albendazole). Using two sequencing methods, the team assembled over 800 high-quality genomes of individual gut bacteria from the mixed genetic material in stool [7].

• Albendazole alone and moxidectin-albendazole caused shifts in which bacteria were present, with only mild consequences for what the bacteria do [7].
• Because the ivermectin dose was set by body weight, heavier participants received more ivermectin in total. Those who received 15 mg or more showed pronounced changes both in which bacteria were present and in their functions [7].
• The resistome, the full set of antibiotic resistance genes carried by the gut bacteria, remained largely stable [7].

The authors write that these findings “confirm that ivermectin can exert antibacterial off-target effects in the human gut beyond those previously observed in vitro”, that is, beyond what laboratory tests had shown. Given ivermectin’s central role in parasite control, they write, its broader effects on the microbiome warrant careful evaluation in future treatment strategies [7].

Studies of albendazole alone

Albendazole, the partner drug in two of these three studies, has also been studied on its own. In five rural villages in western Kenya, stool was tested before albendazole treatment and 3 weeks and 3 months after. After treatment cleared the soil-transmitted worms, bacteria of the order Clostridiales made up a significantly larger share of the gut bacteria and Enterobacteriales a significantly smaller share. Bacterial richness fell even in people who had no worms before treatment, the finding behind the authors’ caution about antimicrobial effects described above. The authors judged the worms’ own effect on the gut bacteria to be small, but found that treating hookworm infection, and clearing Necator americanus in particular, changed the gut bacteria significantly [8].

In Jimma, Ethiopia, stool samples were collected from 132 school-aged children in a mass deworming programme in April and May 2020, before each received a 400 mg dose of albendazole. One year later, 67 of the children gave follow-up samples [9].

• The children’s gut bacteria showed a significant change in diversity: fewer kinds of bacteria were observed, and the community was more even, as measured by the Shannon and Simpson indices, two standard measures of diversity (p < 0.01). The authors describe this as a substantial perturbation of the community’s structure [9].
• In children who had tested negative for worms at the start, six groups of bacteria (genera) became significantly more common after treatment. In children who had eggs of the giant roundworm, whipworm or hookworm detected before treatment, five groups became more common. Only two groups, Senegalimassilia and the Lachnospiraceae ND3007 group, appeared on both lists [9].

The authors conclude that a child’s infection status before treatment influences the changes in the microbiome that follow deworming, and call for controlled animal studies to clarify how deworming treatment shifts the gut bacteria [9]. A third albendazole study, from Ghana, compared people who were cured with people who stayed infected; it is described in the next section.

The Gut Microbiome and How Well Deworming Works

Deworming drugs fail to cure some of the people who take them. The Laos trial team notes that albendazole, the standard treatment, has low cure rates, and that albendazole plus ivermectin, investigated as a more effective combination, has shown variable results without evidence that the worms themselves are resistant [13]. Several studies have looked at whether the gut bacteria a person carries are linked to whether treatment works.

Enterotype and cure rate in Laos

In the Laos trial, the enterotype a person had before treatment was associated with how well albendazole plus ivermectin worked [13]:

• Whipworm cure rate with the combination: 5.8% in enterotype 1, 16.6% in enterotype 2 and 68.8% in enterotype 3 [13].
• Hookworm cure rate with the combination: 31.3% in enterotype 1, 16.6% in enterotype 2 and 78.6% in enterotype 3 [13].

The authors conclude that the enterotype before treatment made it possible to predict the outcome of the combination treatment for whipworm and hookworm; the study’s title describes the link as a correlation [13].

Cured and uncured people in Ghana

In the Kintampo North Municipality of Ghana, a study running from 2018 to 2021 found low hookworm cure rates in some communities after a single 400 mg dose of albendazole. Researchers then compared the gut bacteria of people who were cured with those of people who stayed infected, using stool collected before and 10 to 14 days after treatment [14].

• Hookworm infection was associated with greater species richness (p = 0.0093) [14].
• People cured of hookworm showed what the authors call “a significant reduction in microbiota composition” compared with their own samples from before treatment (p = 0.02). People who failed to clear the infection showed no change (p = 0.35) [14].
• Uninfected people and people who were successfully treated had similar gut bacteria [14].
• Bacteria of the class Clostridia were more abundant in infected people, before or after treatment [14].
• In people who stayed infected, a computer prediction of bacterial functions showed two enriched pathways involving the enzyme pyruvate ferredoxin oxidoreductase (p < 0.05). The authors read this as a sign of more strictly anaerobic resident bacteria, those that live only without oxygen, such as Clostridia [14].

The authors suggest a relationship between an imbalanced gut microbiome and the outcome of albendazole treatment for hookworm. For future studies they propose exploring probiotic supplements given alongside albendazole as a possible way to increase its effectiveness [14].

Liver fluke and triclabendazole in Peru

A link between gut bacteria and treatment response has also been reported with a different drug and parasite. Fasciola hepatica is a liver fluke treated with triclabendazole, and variable efficacy and emerging resistance remain challenges. A 2025 study in Peru sequenced the gut microbiome of 30 infected people and 60 uninfected people matched for age and sex, and followed the microbiome through treatment [15].

• Infection was associated with particular bacterial species and with bacterial pathways linked to survival under stress, along with fewer pathways for microbial growth [15].
• Unexpectedly, people who responded to triclabendazole and cleared the infection had many microbiome features that differed significantly from those of non-responders, both before and after treatment [15].
• Responders had more Firmicutes A and Bacteroides species. Non-responders had more Actinobacteria species, including several from the genera Parolsenella and Bifidobacterium. The two groups also differed in their bacterial metabolic pathways [15].

The authors suggest that the gut microbiota may play a part in how well triclabendazole works [15].

The microbiome and drug resistance in worms

A 2020 review describes the rise of resistance to deworming drugs as alarming. It argues that emerging research points to opportunities to counter this resistance by using the gut microbiome as a resource, both for discovering new treatments and for informing the responsible use of the existing drugs [16].

None of the human studies described on this page changed people’s gut bacteria to test whether that alters the cure rate. The Laos and Ghana findings are associations, and the Ghana authors list probiotic supplements given with albendazole as a possibility for future studies [13][14].

The Skin Microbiome and Rosacea

Ivermectin is also used as a cream for rosacea, and researchers have looked at what it does to the microbes of the skin [17]. The Topical Ivermectin page covers the cream and its trials in detail.

Rosacea is a long-lasting inflammatory condition of the skin of the central face. A 2025 review describes it as driven by immune dysregulation, genetic predisposition, a faulty outer skin barrier and microbial imbalance. It says recent evidence implicates both the gut and the skin microbiomes in driving the inflammation and its severity, through direct immune interactions and through the gut-skin axis, the two-way links between the gut and the skin. The review lists an increase in species it describes as proinflammatory, Demodex folliculorum (a skin mite), Staphylococcus epidermidis and Bacillus oleronius, alongside a decline in protective species such as Cutibacterium acnes. It describes treatments that now aim to restore microbial balance: narrow-spectrum antibiotics, anthelmintics (the drug class that includes ivermectin), probiotics applied to the skin or taken by mouth, and “microbiome-friendly” skin care [18].

What ivermectin cream did to the skin’s microbes

A 2025 study followed people with rosacea before and after 30 days of treatment with 1% ivermectin cream. It measured the density of Demodex folliculorum mites, the bacteria living on the skin and the host’s transcriptome, the pattern of genes switched on in the skin [17].

• At day 30, mite density had fallen markedly in 87.5% of the patients [17].
• Before treatment, the patients’ skin had less Cutibacterium acnes and more Staphylococcus epidermidis than the skin of healthy volunteers [17].
• Snodgrassella alvi, a bacterium known as an insect symbiont (a microbe that lives in partnership with insects), was recovered from one patient heavily colonised by Demodex mites, and was gone after treatment at day 30 [17].
• The cream did not affect the imbalance of skin bacteria [17].
• The gene activity of the skin moved significantly toward normal, and the authors defined an “ivermectin transcriptomic signature” [17].

The authors concluded that rosacea lesions are associated with an imbalance of skin bacteria, but that the improvement in clinical signs during treatment with ivermectin cream is not associated with the bacteria returning to normal. It is associated instead with less disturbed gene activity in the skin and fewer mites [17]. In other words, the cream reduced the mites, which the 2025 review counts among the proinflammatory species, without rebalancing the skin bacteria [17][18].

Beyond the Human Gut

Ivermectin belongs to the avermectins, a family of compounds that also includes the farm insecticides abamectin and emamectin benzoate and the veterinary drug eprinomectin. The three studies below are about bees, a crop pest and soil, not people.

Honey bees

In a 2024 study, abamectin packaged in nanocapsules (tiny capsules) caused no obvious damage to the gut tissue of honey bees, but it lowered their digestive enzyme activity and disrupted their gut microbiome, reducing beneficial bacteria such as Bifidobacterium and Lactobacillus. These changes were associated with lower activity of digestive enzymes, including lipase, which digests fats [19].

A moth pest of fruit trees

Caterpillars of Grapholita molesta, the oriental fruit moth, move from feeding on peach shoots to feeding on apples. In a 2023 study, caterpillars feeding on the fruit were significantly less sensitive to the insecticide emamectin benzoate, and disrupting their gut bacteria with antibiotics significantly increased their sensitivity to it. The authors suggest that both the caterpillars’ detoxifying cytochrome P450 enzymes and their gut bacteria help them adapt to the insecticide [20].

Soil

Deworming drugs given to livestock are only partly broken down in the animals, and manure carries them into farm soils. In a 2023 study, two soils received repeated doses of albendazole, ivermectin and eprinomectin. Residues of ivermectin and eprinomectin built up in both soils. All three drugs inhibited nitrification, the process by which soil microbes turn ammonia into nitrate, reduced the numbers of ammonia-oxidising bacteria and archaea (single-celled microbes distinct from bacteria), and caused dose-dependent shifts in the diversity of soil bacteria, fungi and protists; albendazole had the most consistent effect. The authors call this the first evidence of an unexpected toxicity of these drugs to key groups of soil microbes, one that might need to be taken into account by regulators [21].

What Is Not Yet Known

• Every study described here of ivermectin and the gut bacteria of people was in people infected with worms, and in each one ivermectin was given with a second deworming drug [6][13][7]. Among the studies on this page, ivermectin alone was tested on gut bacteria from healthy people only in the 2023 laboratory simulator, whose authors note that earlier information came from people who were ill [1].
• The health effects of the changes remain open. The 2018 authors call for studies of the possible health outcomes of the changes they saw [6], and the Kenyan authors for follow-up studies to determine the health consequences of the changes after deworming [8].
• How long the changes last is not settled. With ivermectin, the rise in Bacteroidetes after tribendimidine plus ivermectin had gone by three weeks [6], and the changes in the gut simulator were temporary [1]. After albendazole alone, the Ethiopian children’s gut bacteria still showed a significant change in diversity one year later [9].
• On antibiotic resistance, the evidence so far points two ways. Gut bacteria repeatedly exposed to ivermectin and moxidectin in the laboratory became, to some extent, less sensitive to antibiotics [2], while in the 2026 trial the antibiotic resistance genes of the gut bacteria remained largely stable [7].
• The 2026 trial authors write that ivermectin’s broader effects on the microbiome warrant careful evaluation in future treatment strategies [7].

Key Research Papers

1. Liu L, Mahalak KK, Bobokalonov JT, Narrowe AB, Firrman J, Lemons JMS, et al. Impact of Ivermectin on the Gut Microbial Ecosystem. Int J Mol Sci. 2023;24(22). PubMed PMID: 38003317
2. Dommann J, Keiser J, Garneau J, Gandelin A, Casanova C, Keller PM, et al. Exposure of gut bacterial isolates to the anthelminthic drugs, ivermectin and moxidectin, leads to antibiotic-like phenotypes of growth inhibition and adaptation. Commun Biol. 2024;7(1):1566. PubMed PMID: 39604486
3. Belo TCA, Santos NCM, Souto BS, Rosa CP, Santos AS, Oliveira KC, et al. Ivermectin-induced bacterial gut dysbiosis does not increase susceptibility to Pseudomonas aeruginosa lung infection but exacerbates liver damage. Microbes Infect. 2023;25(4):105080. PubMed PMID: 36503045
4. Ma X, Li J, Yang L, Liu H, Zhu Y, Ren H, et al. Short Term Effect of Ivermectin on the Bacterial Microbiota from Fecal Samples in Chinchillas (Chinchilla lanigera). Vet Sci. 2023;10(2). PubMed PMID: 36851473
5. Fulham M, Power M, Gray R. Gut microbiota of endangered Australian sea lion pups is unchanged by topical ivermectin treatment for endemic hookworm infection. Front Microbiol. 2022;13:1048013. PubMed PMID: 36601397
6. Schneeberger PHH, Coulibaly JT, Gueuning M, Moser W, Coburn B, Frey JE, et al. Off-target effects of tribendimidine, tribendimidine plus ivermectin, tribendimidine plus oxantel-pamoate, and albendazole plus oxantel-pamoate on the human gut microbiota. Int J Parasitol Drugs Drug Resist. 2018;8(3):372-378. PubMed PMID: 30007544
7. Dommann J, Sprecher VP, Beisel C, Ballmer D, Hürlimann E, Coulibaly JT, et al. Combined high-quality metagenomics reveals off-target effects of albendazole, ivermectin-albendazole and moxidectin-albendazole on the human gut bacteria. NPJ Biofilms Microbiomes. 2026;12(1). PubMed PMID: 42209510
8. Easton AV, Quiñones M, Vujkovic-Cvijin I, Oliveira RG, Kepha S, Odiere MR, et al. The Impact of Anthelmintic Treatment on Human Gut Microbiota Based on Cross-Sectional and Pre- and Postdeworming Comparisons in Western Kenya. mBio. 2019;10(2). PubMed PMID: 31015324
9. Tikhonova P, Mekonnen Z, Belanger KD, Ay A, Davenport ER, Taye B. Microbiome responses to anthelmintic treatment depend on pre-treatment helminth infection status in young Ethiopian children. Commun Med (Lond). 2026;6(1). PubMed PMID: 42062458
10. Dicks LMT, Deane SM, Grobbelaar MJ. Could the COVID-19-Driven Increased Use of Ivermectin Lead to Incidents of Imbalanced Gut Microbiota and Dysbiosis? Probiotics Antimicrob Proteins. 2022;14(2):217-223. PubMed PMID: 35218001
11. Gordon CA, Krause L, McManus DP, Morrison M, Weerakoon KG, Connor MC, et al. Helminths, polyparasitism, and the gut microbiome in the Philippines. Int J Parasitol. 2020;50(3):217-225. PubMed PMID: 32135180
12. Sabey KA, Castro A, Song SJ, Knight R, Ezenwa VO. Anthelmintic Treatment Reveals Sex-Dependent Worm-Gut Microbiota Interactions. Parasite Immunol. 2024;46(12):e70000. PubMed PMID: 39707820
13. Schneeberger PHH, Gueuning M, Welsche S, Hürlimann E, Dommann J, Häberli C, et al. Different gut microbial communities correlate with efficacy of albendazole-ivermectin against soil-transmitted helminthiases. Nat Commun. 2022;13(1):1063. PubMed PMID: 35217670
14. Appiah-Twum F, Akorli J, Okyere L, Sagoe K, Osabutey D, Cappello M, et al. The effect of single dose albendazole (400 mg) treatment on the human gut microbiome of hookworm-infected Ghanaian individuals. Sci Rep. 2023;13(1):11302. PubMed PMID: 37438457
15. Lee G, Rosa BA, Fernandez-Baca MV, Martin J, Ore RA, Ortiz P, et al. Distinct gut microbiome features characterize Fasciola hepatica infection and predict triclabendazole treatment outcomes in Peruvian patients. Front Cell Infect Microbiol. 2025;15:1555171. PubMed PMID: 40129931
16. Sharpton TJ, Combrink L, Arnold HK, Gaulke CA, Kent M. Harnessing the gut microbiome in the fight against anthelminthic drug resistance. Curr Opin Microbiol. 2020;53:26-34. PubMed PMID: 32114334
17. Olah P, Reuvers N, Radai Z, Varadi A, van Lierop A, Wachtmeister T, et al. Microbe-Host Interaction in Rosacea and Its Modulation through Topical Ivermectin. J Invest Dermatol. 2025;145(10):2576-2587.e8. PubMed PMID: 40220854
18. Asees A, Sadur A, Choudhary S. The Skin Microbiome in Rosacea: Mechanisms, Gut-Skin Interactions, and Therapeutic Implications. Cutis. 2025;116(1):20-23. PubMed PMID: 40875939
19. Guo D, Wang Y, Li Z, Zhang DX, Wang C, Wang H, et al. Effects of abamectin nanocapsules on bees through host physiology, immune function, and gut microbiome. Sci Total Environ. 2024;930:172738. PubMed PMID: 38670362
20. Liu Y, Yu J, Zhu F, Shen Z, Jiang H, Li Z, et al. Function of Cytochrome P450s and Gut Microbiome in Biopesticide Adaptation of Grapholita molesta on Different Host Diets. Int J Mol Sci. 2023;24(20). PubMed PMID: 37895115
21. Lagos S, Tsetsekos G, Mastrogianopoulos S, Tyligada M, Diamanti L, Vasileiadis S, et al. Interactions of anthelmintic veterinary drugs with the soil microbiota: Toxicity or enhanced biodegradation? Environ Pollut. 2023;334:122135. PubMed PMID: 37406753

PubMed Topic Searches

1. PubMed: Ivermectin and the gut microbiome
2. PubMed: Ivermectin-albendazole and the gut microbiome
3. PubMed: Deworming treatment and the gut microbiome
4. PubMed: Rosacea, ivermectin and the skin microbiome

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Connections

• Ivermectin
• All Drugs
• Topical Ivermectin
• Veterinary Ivermectin
• Ivermectin: Antibacterial Research
• Ivermectin for Gum Disease
• How Ivermectin Works
• Albendazole
• Oxantel Pamoate
• The Gut Microbiome and Parasites
• Cancer and Parasites
• Whipworm
• Hookworm
• Ascaris (Giant Roundworm)
• Fasciola (Liver Fluke)
• Your Microbiome
• How Bacteria Beat Antibiotics
• Rosacea
• Oral Microbiome

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