The effects of four antibiotics on the yeast flora of the human gut were evaluated. Forty adult cancer patients who received therapy with amoxicillin-clavulanate, ciprofloxacin, sulfamethoxazole-trimethoprim or ampicillin were studied prospectively. Quantitative stool cultures for yeasts were performed immediately before, at the end of and one week after the end of the antibiotic treatment. Amoxicillin-clavulanate caused a higher and more persistent increase in gastrointestinal colonization by yeasts compared to ciprofloxacin, sulfamethoxazole-trimethoprim or ampicillin. The present results are similar to those obtained in a mouse model of gastrointestinal colonization by Candida albicans when the same antibiotics were used.
Three-month old, male Crl:CD1(ICR) BR mice, were fed food containing Candida albicans, while other mice of the same type were fed regular food. Both groups of mice were subsequently given orally either antibiotics or normal saline for a 10-day period. The stools of all mice were cultured before, at the end, and one week after the end of the antibiotic treatment, to determine the level of gut colonization by the yeast. The mice fed Candida and treated with antibiotics had substantially higher Candida counts in their stools than control mice fed C. albicans and treated with saline. The concentrations of Candida in the stools of mice treated with tetracycline were much higher when compared to those of mice treated with metronidazole and norfloxacin. Tetracycline was associated with a statistically significant increase of gastrointestinal Candida colonization. Yeast was not found in the stools of mice fed regular food and treated with antibiotics or saline. Histopathologic examination did not reveal dissemination of Candida in the visceral organs of any mouse.
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