ANAS SALEH M ALJOHANI, SADAF FAROOQUI, AHMED ABDULRAHMAN NASHI ALHARBI, MAHA FAHAD MOHAMMED HASSAN, AHMED AYIDH DAGASH ALAKLOBI , MOHAMMED FAHAD ALMUTAIRI, MESHAL DHUBAYYIB R ALNAWMASI, ABDDELHADI YASSIN ABDELHADI YASSIN
DOI: https://doi.org/Objective: The aim of this systematic review is to evaluate the role of exercise as a neuroprotective strategy in restoring gut–brain homeostasis during and after antibiotic treatment. Antibiotic-induced gut dysbiosis is associated with mental health disturbances, including anxiety, depression, and cognitive dysfunction. This review explores the potential of exercise to mitigate these negative effects and promote mental health by modulating the gut microbiota and reducing neuroinflammation.
Methods: A comprehensive search was conducted across PubMed, PsycINFO, and Scopus for studies published between 2015 and 2025. Studies were included if they assessed the impact of exercise (aerobic, resistance, or mind-body exercises) on gut microbiota composition and mental health outcomes during or after antibiotic treatment. Eligible studies were randomized controlled trials (RCTs), observational studies, and longitudinal studies. A total of 20 studies met the inclusion criteria. Data extraction included information on exercise type, frequency, intensity, duration, and its effects on gut–brain axis health and neuroprotection. Quality assessment was performed using the Cochrane Risk of Bias tool for RCTs and the Newcastle-Ottawa Scale for observational studies.
Results: Exercise was shown to have a significant positive impact on both gut microbiota composition and mental health outcomes in individuals undergoing or recovering from antibiotic treatment. Aerobic exercise (e.g., cycling, walking) and resistance training both contributed to the restoration of gut microbial diversity and the reduction of harmful bacteria. Additionally, exercise was associated with decreased anxiety, depression, and cognitive dysfunction. Mind-body exercises, such as yoga, were particularly effective in reducing stress and enhancing psychological resilience. The most effective exercise regimens involved moderate-intensity aerobic exercise performed 3-5 times per week for 30-45 minutes, and resistance training sessions conducted 2-3 times per week.
Conclusions: This review provides evidence that exercise is an effective neuroprotective strategy for restoring gut–brain homeostasis during and after antibiotic treatment. By modulating gut microbiota and reducing systemic inflammation, exercise not only improves mental health outcomes but also promotes neuroprotection. Further studies are required to explore the specific mechanisms through which exercise affects the gut–brain axis and to identify the most optimal exercise regimens for mental health and neuroprotection in individuals undergoing antibiotic treatment.
