Ceftriaxone and Cefotaxime Have Similar Effects on the Intestinal Microbiota in Human Volunteers Treated by Standard-Dose Regimens

Abstract

Ceftriaxone has a higher biliary elimination than cefotaxime (40% versus 10%), which may result in a more pronounced impact on the intestinal microbiota. We performed a monocenter, randomized open-label clinical trial in 22 healthy volunteers treated by intravenous ceftriaxone (1 g/24 h) or cefotaxime (1 g/8 h) for 3 days. We collected fecal samples for phenotypic analyses, 16S rRNA gene profiling, and measurement of the antibiotic concentration and compared the groups for the evolution of microbial counts and indices of bacterial diversity over time. Plasma samples were drawn at day 3 for pharmacokinetic analysis. The emergence of 3rd-generation-cephalosporin-resistant Gram-negative enteric bacilli (Enterobacterales), Enterococcus spp., or noncommensal microorganisms was not significantly different between the groups. Both antibiotics reduced the counts of total Gram-negative enteric bacilli and decreased the bacterial diversity, but the differences between the groups were not significant. All but one volunteer from each group exhibited undetectable levels of antibiotic in feces. Plasma pharmacokinetic endpoints were not correlated to alteration of the bacterial diversity of the gut. Both antibiotics markedly impacted the intestinal microbiota, but no significant differences were detected when standard clinical doses were administered for 3 days. This might be related to the similar daily amounts of antibiotics excreted through the bile using a clinical regimen. (This study has been registered at ClinicalTrials.gov under identifier NCT02659033.)

Effect of mare’s milk prebiotic supplementation on the gut microbiome and the immune system following antibiotic therapy

“…The results also showed that Bacteroides abundance was not significantly altered by cephalosporin. It supports previous findings investigating the effect of cephalosporins on the intestinal microbiota (Burdet et al 2019;Rashid et al 2015). Apart from a decrease in the abundance of several genera, there was an increase in Christensenella, Rothia, Abiotrophia, Acinetobacter, Anaerotruncus, Holdemania, and Turicibacter.…”

Effect of cinnamon essential oil on gut microbiota in the mouse model of dextran sodium sulfate‐induced colitis

“…The research data revealed that CEO, but not CFT, had the ability to enhance the intestinal microbial richness and diversity in colitis mice, which was generally negatively associated with the severity of intestinal‐related diseases . Similarly, Burdet et al pointed out that both ceftriaxone and cefotaxime exhibited a profound reduction on bacterial diversity (Shannon index and number of OUTs) in humans. Antibiotic therapy also reduced the diversity of fecal microbiota in children with ulcerative colitis .…”

Gut Microbiota, Antibiotic Therapy and Antimicrobial Resistance: A Narrative Review

“…This explains the discrepancies between studies on antibiotic effects. For example, in their study Grohs et al found ecological benefits of substitution from ceftriaxone to cefotaxime [11], while a recent study in healthy volunteers showed no difference between the two third-generation cephalosporins [86]. This difference between the results can be explained by methodological considerations.…”