Effect of antimicrobial agents on the ecological balance of human microflora

Sullivan, Åsa; Edlund, Charlotta; Nord, Carl Erik

doi:10.1016/s1473-3099(01)00066-4

Cited by 701 publications

(591 citation statements)

References 56 publications

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“…One possible explanation for a putative effect is that the use of antimicrobials serves as an indicator of infections possibly involved in pathogenesis of type 1 diabetes [1]. The use of antimicrobials, especially of those with a broad antibacterial spectrum and those that are incompletely absorbed, induces marked changes in gut flora [3]. This may not only disturb the maturation of the immune system, but may also make the gut more vulnerable to other environmental triggers.…”

Section: Discussionmentioning

confidence: 99%

Use of antimicrobials and risk of type 1 diabetes in a population-based mother–child cohort

Kilkkinen¹,

Virtanen

Klaukka

et al. 2005

Diabetologia

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Aims/hypothesis: The aim of this study was to investigate whether the use of antimicrobials is associated with the risk of childhood type 1 diabetes. Materials and methods: The study population included all children born in Finland between 1996 and 2000 who were diagnosed with type 1 diabetes by the end of 2002. For each case (n=437), four matched controls were selected. Data on diabetes and the maternal use of antimicrobials was derived from nationwide registries. Results: Maternal use of phenoxymethyl penicillins (odds ratio [OR]=1.70, 95% CI 1.08-2.68, p=0.022) or quinolone antimicrobials (OR=2.43, 95% CI 1.16-5.10, p=0.019) before pregnancy was associated with an increased risk of type 1 diabetes in the child, whereas the use of other specific antimicrobials was not related to the risk. The risk was also higher among mother-child pairs where macrolides were used both by the mother before pregnancy and by the child, compared with pairs where neither used macrolides (OR=1.76, 95% CI 1.05-2.94, p=0.032). Maternal use of antimicrobials during pregnancy was not associated with an increased risk. The high use of antimicrobials by the child (more than seven vs seven or less purchases) was related to greater risk (OR=1.66, 95% CI 1.24-2.24, p=0.001). Conclusions/ interpretation: Overall, the use of antimicrobials before pregnancy, during pregnancy or during childhood was not related to the risk of childhood type 1 diabetes. However, the use of some specific antimicrobials by the mother before pregnancy and by the child may be associated with an increased risk. Further studies are needed to confirm these associations and to elucidate the underlying mechanisms of action.

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Section: Discussionmentioning

confidence: 99%

Use of antimicrobials and risk of type 1 diabetes in a population-based mother–child cohort

Kilkkinen¹,

Virtanen

Klaukka

et al. 2005

Diabetologia

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“…Pseudomembranous colitis is a highly relevant clinical example where an overgrowth of Clostridium difficile leads to a potentially life-threatening infectious colitis during the course of antibiotic treatment. 10 Other side effects of antibiotics are disturbances of host metabolism and absorption of vitamins, as well as increasing numbers of antibiotic-resistant bacterial strains. Even after shortterm AB treatment these consequences can persist for years.…”

Section: Introductionmentioning

confidence: 99%

Dynamic changes of the luminal and mucosa-associated gut microbiota during and after antibiotic therapy with paromomycin

Heinsen

Knecht

Neulinger³

et al. 2015

Gut Microbes

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(2015) Dynamic changes of the luminal and mucosa-associated gut microbiota during and after antibiotic therapy with paromomycin, Gut Microbes, 6:4, 243-254, DOI: 10.1080/19490976.2015 To link to this article: https://doi.org/10. 1080/19490976.2015 Keywords: 16S rRNA gene, antibiotics, lumen, microbiota, mucosaGut microbiota play a key role in the host's health system. Broad antibiotic therapy is known to disrupt the microbial balance affecting pathogenic as well as host-associated microbes. The aim of the present study was to investigate the influence of antibiotic paromomycin on the luminal and mucosa-associated microbiota at the DNA (abundance) and RNA (potential activity) level as well as to identify possible differences. The influence of antibiotic treatment on intestinal microbiota was investigated in 5 healthy individuals (age range: 20-22 years). All participants received the antibiotic paromomycin for 3 d. Fecal samples as well as sigmoidal biopsies were collected before and immediately after cessation of antibiotic treatment as well as after a recovery phase of 42 d. Compartment-and treatment statusspecific indicator operational taxonomic units (OTUs) as well as abundance-and activity-specific patterns were identified by 16S rRNA and 16S rRNA gene amplicon libraries and high-throughput pyrosequencing. Microbial composition of lumen and mucosa were significantly different at the DNA compared to the RNA level. Antibiotic treatment resulted in changes of the microbiota, affecting the luminal and mucosal bacteria in a similar way. Several OTUs were identified as compartment-and/or treatment status-specific. Abundance and activity patterns of some indicator OTUs differed considerably. The study shows fundamental changes in composition of gut microbiota under antibiotic therapy at both the potential activity and the abundance level at different treatment status. It may help to understand the complex processes of gut microbiota changes involved in resilience mechanisms and on development of antibiotic-associated clinical diseases.

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“…The issue that administration of antimicrobial agents causes disturbances in the ecological balance between the host and the microorganisms and thus has a potential to interfere with initial gut colonization in neonates cannot be ignored [2].…”

Section: Introductionmentioning

confidence: 99%

Impact of empiric antibiotic regimen on bowel colonization in neonates with suspected early onset sepsis

Parm

Metsvaht

Sepp

et al. 2010

Eur J Clin Microbiol Infect Dis

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HAL is a multi-disciplinary open access archive for the deposit and dissemination of scientific research documents, whether they are published or not. The documents may come from teaching and research institutions in France or abroad, or from public or private research centers. L'archive ouverte pluridisciplinaire HAL, est destinée au dépôt et à la diffusion de documents scientifiques de niveau recherche, publiés ou non, émanant des établissements d'enseignement et de recherche français ou étrangers, des laboratoires publics ou privés. Abstract The purpose of this study was to compare the impact of ampicillin and penicillin used for empiric treatment of early onset sepsis (EOS) on initial gut colonization by aerobic and facultative anaerobic microorganisms. A cluster-randomized, two-center, switch-over study was conducted in two paediatric intensive care units in Estonia and included 276 neonates. Rectal swabs were collected twice a week until discharge or day 60. Colonizing microbes were identified on species level and tested for ampicillin resistance (AR). The number of patients colonized with Gram negative microorganisms and Candida spp was similar in both treatment arms but ampicillin resulted in longer colonization duration (CD) of K. pneumonia (p=0.012), AR Serratia spp (p=0.012) and Candida spp (p=0.02) and penicillin in that of AR Acinetobacter spp (p=0.001). As for Gram positive microorganisms penicillin treatment was associated with a greater number of colonized patients and higher CD of Enterococcus spp and S. aureus but lower ones of S. haemolyticus and S. hominis. Influence of ampicillin and penicillin on initial gut colonization is somewhat different but these differences are of low clinical relevance and should not be a limiting step when choosing between these two antibiotics for the empiric treatment of EOS.

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Effect of antimicrobial agents on the ecological balance of human microflora

Cited by 701 publications

References 56 publications

Use of antimicrobials and risk of type 1 diabetes in a population-based mother–child cohort

Use of antimicrobials and risk of type 1 diabetes in a population-based mother–child cohort

Dynamic changes of the luminal and mucosa-associated gut microbiota during and after antibiotic therapy with paromomycin

Impact of empiric antibiotic regimen on bowel colonization in neonates with suspected early onset sepsis

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