Impact of injectable cephalosporins on the gastrointestinal microflora: Observations in healthy volunteers and hospitalized patients

Knothe, H; Dette, G. A.; Shah, P. M.

doi:10.1007/bf01644233

Cited by 30 publications

(8 citation statements)

References 6 publications

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“…Resistance to ceftazidime was not observed 62 . Similar findings were observed in a study performed by Knothe and colleagues 63 …”

Section: Effect Of Antimicrobial Therapy On the Gut Microbiomesupporting

confidence: 86%

“…The impact of ceftazidime on the faecal microbiome was studied in eight healthy volunteers. As expected, the intestinal Enterobacteriaceae content was suppressed at the end of the treatment course 62 , 63 . Intestinal anaerobic organisms such as Lactobacillus bifidus had a slight decrease and Bacteroides fragilis had minimal fluctuations overall.…”

Section: Effect Of Antimicrobial Therapy On the Gut Microbiomesupporting

confidence: 74%

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Impact of antimicrobial therapy on the gut microbiome

Bhalodi

Engelen

Virk

et al. 2019

Journal of Antimicrobial Chemotherapy

167

118

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The gut microbiome is now considered an organ unto itself and plays an important role in health maintenance and recovery from critical illness. The commensal organisms responsible for the framework of the gut microbiome are valuable in protection against disease and various physiological tasks. Critical illness and the associated interventions have a detrimental impact on the microbiome. While antimicrobials are one of the fundamental and often life-saving modalities in septic patients, they can also pave the way for subsequent harm because of the resulting damage to the gut microbiome. Contributing to many of the non-specific signs and symptoms of sepsis, the balance between the overuse of antimicrobials and the clinical need in these situations is often difficult to delineate. Given the potency of antimicrobials utilized to treat septic patients, the effects on the gut microbiome are often rapid and long-lasting, in which case full recovery may never be observed. The overgrowth of opportunistic pathogens is of significant concern as they can lead to infections that become increasingly difficult to treat. Continued research to understand the disturbances within the gut microbiome of critically ill patients and their outcomes is essential to help develop future therapies to circumvent damage to, or restore, the microbiome. In this review, we discuss the impact of the antimicrobials often used for the treatment of sepsis on the gut microbiota.

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“…Resistance to ceftazidime was not observed 62 . Similar findings were observed in a study performed by Knothe and colleagues 63 …”

Section: Effect Of Antimicrobial Therapy On the Gut Microbiomesupporting

confidence: 86%

Section: Effect Of Antimicrobial Therapy On the Gut Microbiomesupporting

confidence: 74%

Impact of antimicrobial therapy on the gut microbiome

Bhalodi

Engelen

Virk

et al. 2019

Journal of Antimicrobial Chemotherapy

167

118

View full text Add to dashboard Cite

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“…Antibiotic therapy can disturb the indigenous intestinal flora, resulting in a significant decrease in Lactobacillus spp. (3,20,21), which is a common problem in treatment of infectious diseases and postoperative septic complications (17). A patient with a suppressed indigenous flora is more susceptible to secondary infections and overgrowth of undesired microorganisms, leading to diarrhea and even pseudomembraneous colitis and development of distant organ failure (5,17,22).…”

mentioning

confidence: 99%

Administration of different Lactobacillus strains in fermented oatmeal soup: in vivo colonization of human intestinal mucosa and effect on the indigenous flora

Johansson

Molin

Jeppsson

et al. 1993

Appl Environ Microbiol

375

164

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In vivo colonization by different Lactobacillus strains on human intestinal mucosa of healthy volunteers was studied together with the effect of Lactobacillus administration on different groups of indigenous bacteria. A total of 19 test strains were administered in fermented oatmeal soup containing 5 x 10(6) CFU of each strain per ml by using a dose of 100 ml of soup per day for 10 days. Biopsies were taken from both the upper jejunum and the rectum 1 day before administration was started and 1 and 11 days after administration was terminated. The administration significantly increased the Lactobacillus counts on the jejunum mucosa, and high levels remained 11 days after administration was terminated. The levels of streptococci increased by 10- to 100-fold in two persons, and the levels of sulfite-reducing clostridia in the jejunum decreased by 10- to 100-fold in three of the volunteers 1 day after administration was terminated. In recta, the anaerobic bacterium counts and the gram-negative anaerobic bacterium counts decreased significantly by the end of administration. Furthermore, a decrease in the number of members of the Enterobacteriaceae by 1,000-fold was observed on the rectal mucosa of two persons. Randomly picked Lactobacillus isolates were identified phenotypically by API 50CH tests and genotypically by the plasmid profiles of strains and by restriction endonuclease analysis of chromosomal DNAs.(ABSTRACT TRUNCATED AT 250 WORDS)

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“…Jones (1985) also reported that the incidence of enterococcal superinfection after Ctx therapy was lower than that in patients given other betalactam antibiotics. Cefotaxime is also thought to affect the human faecal flora less than other third generation cephalosporins (Knothe, Dette & Shah, 1985;Burdon et al 1985). However, reported results in this area are difficult to evaluate: Lambert-Zechovsky et al (1985) described a rise in the faecal enterococci in children treated with Ctx whereas Guggenbichler and co-workers (1985) demnonstrated a similar rise in only 1 of 20 treated children.…”

Section: Discussionmentioning

confidence: 99%

The effect of selective decontamination of the digestive tract with the addition of systemic cefotaxime on the aerobic faecal flora of mice

et al. 1987

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SUMMARYThe administration per-orally to mice of the non-absorbable antibiotics polymyxin E, tobramycin and amphotericin B resulted in the elimination of detectable aerobic gram-negative rods from the faecal flora without affecting the total viable aerobic count. The addition of parental cefotaxime to the regime caused a fall in the number of aerobic lactobacilli and an increase in the number of enterococci. The rise was associated with the translocation of viable enterococci to the mesenteric lymph nodes and the spleen. The changes induced by cefotaxime were reversed when the antibiotic was withdrawn. Following withdrawal of all antibiotics the total aerobic faecal flora increased to above normal levels, but there was no associated diarrhoea. Attempts to implant exogenous enterobacteria into the digestive tract resulted in only low level colonization both in treated mice and in control mice. These results may have implications for the use of this antibiotic regime for selective decontamination of the digestive tract in humans, particularly those who are immunocompromised.

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Impact of injectable cephalosporins on the gastrointestinal microflora: Observations in healthy volunteers and hospitalized patients

Cited by 30 publications

References 6 publications

Impact of antimicrobial therapy on the gut microbiome

Impact of antimicrobial therapy on the gut microbiome

Administration of different Lactobacillus strains in fermented oatmeal soup: in vivo colonization of human intestinal mucosa and effect on the indigenous flora

The effect of selective decontamination of the digestive tract with the addition of systemic cefotaxime on the aerobic faecal flora of mice

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