Microbiota Modulation as an Approach to Prevent the Use of Antimicrobials Associated with Canine Atopic Dermatitis

Modern lifestyle factors-such as dietary changes, reduced microbial exposure, and genetic susceptibility-profoundly influence the composition and function of the commensal microbiota. Additionally, dysregulation of the gut microbiota has been linked to impaired immune responses and an increased prevalence of skin disorders, including allergies and inflammatory conditions, thereby underscoring the importance of the gut-skin axis. Chronic gastrointestinal and dermatological manifestations frequently lead to excessive antimicrobial use, which in turn fosters the selection and colonization of multidrug-resistant organisms, most notably methicillin-resistant Staphylococcus pseudintermedius (MRSP) in companion animals. Furthermore, the growing threat of antimicrobial resistance (AMR) to both human and animal health reinforces the urgent need for alternative strategies like modulating the gut microbiota, which also contributes to the prevention and management of skin conditions. Against this backdrop, the present review aims to evaluate microbiota modulation as an alternative and complementary approach to antimicrobial therapy, focusing on its ability to restore microbial balance, strengthen epithelial barrier integrity, and improve overall health outcomes in dogs affected by atopic dermatitis (cAD). Promising interventions-including probiotics, prebiotics, postbiotics, and fecal microbiota transplantation-are highlighted for their potential role in mitigating AMR and warrant further investigation as sustainable therapeutic strategies.