Antibiotic-induced dysbiosis disrupts the gut microbiota's biochemical symphony, impairing metabolic, immune, and signalling functions essential for health. This multidisciplinary review consolidates molecular, biochemical, and translational insights into biotechnological strategies for microbiota restoration. Topics include engineered probiotics, synthetic microbial consortia, phage-based therapeutics, and metabolic reconstruction of short-chain fatty acid and bile acid pathways. Computational modelling and multi-omics integration are examined as tools for pathway prediction and ecological resilience testing. Clinical and ethical perspectives highlight ongoing trials, biosafety frameworks, and equitable access in low-resource settings. Synthesising findings from systems biology and clinical translation, the review concludes that the next frontier of microbiome therapeutics lies in rationally engineered metabolic restoration—a convergence of biotechnology, computation, and ethics aimed at transforming post-antibiotic medicine into a programmable, functionally resilient ecosystem
