SUMMARYThe influence of treatment with increasing oral doses of three absorbable antibiotics on the colonization resistance of the digestive tract was investigated in mice. Mice treated with ampicillin or epicillin in any of the applied doses had a strongly decreased colonization resistance as demonstrated by ‘bacterial over-growth’ after contamination with resistant strains ofEscherichia coli. After a treatment period of 2 weeks,Streptococcus faecalisbecame resistant in a number of animals. Oral treatment with cephradine on the other hand had no obvious influence on the endogenous flora of the mice, nor was the colonization resistance decreased.
The suppressive effect of amikacin, gentamicin, tobramycin and paromomycin on the aerobic endogenous flora and on the colonization resistance of the digestive tract was tested by administering one of the antibiotics orally at five different dose levels. At a certain dose level, all antibiotics suppressed the endogenous Enterobacteriaceae species. Amikacin was particularly effective in this respect. Low doses of amikacin rapidly destroyed the colonization resistance. This resistance only remained unaffected in animals treated with tobramycin in doses that were still adequate to completely suppress the endogenous Enterobacteriaceae species. We concluded that of all the antibiotics tested in this study, only tobramycin may have a future in (clinical) application for the selective decontamination of the digestive tract. Selective decontamination can be considered an effective method for infection prevention in leukopenic patients.
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