Effect of erythromycin and clindamycin on the indigenous human anaerobic flora and new colonization of the gastrointestinal tract

Heimdahl, Anders; Nord, Carl Erik

doi:10.1007/bf02014139

Cited by 55 publications

(11 citation statements)

References 20 publications

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“…Thus the present findings indicate that dirithromycin has an ecological impact on the human oral and intestinal microflora. Similar findings have been reported for erythromycin (5).…”

Section: Methodssupporting

confidence: 87%

Impact of dirithromycin on the normal oral and intestinal microflora

Eckernäs¹,

Grahnén²,

Nord

1991

Eur. J. Clin. Microbiol. Infect. Dis.

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Twenty healthy volunteers received 500 mg of dirithromycin orally once daily for seven days. The concentrations of dirithromycin in serum and saliva were low (less than or equal to 1.5 mg/l), while the faecal concentrations were high (greater than or equal to 12 mg/kg). The numbers of streptococci, Haemophilus and Neisseria increased in the aerobic oral microflora during dirithromycin treatment. In the aerobic intestinal microflora, the numbers of enterobacteria decreased significantly, while streptococci and staphylococci increased. New colonizing dirithromycin resistant enterobacteria were isolated during and after treatment. The anaerobic intestinal microflora was also affected; thus the numbers of gram-positive cocci, bifidobacteria, eubacteria and bacteroides decreased, while the numbers of clostridia and lactobacilli increased. Dirithromycin has an ecological impact on the oral and intestinal microflora.

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“…Thus the present findings indicate that dirithromycin has an ecological impact on the human oral and intestinal microflora. Similar findings have been reported for erythromycin (5).…”

Section: Methodssupporting

confidence: 87%

Impact of dirithromycin on the normal oral and intestinal microflora

Eckernäs¹,

Grahnén²,

Nord

1991

Eur. J. Clin. Microbiol. Infect. Dis.

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“…Oral treatment with clindamycin was shown to cause fecal bile pigment pattern similar to that of germfree animals [16] with return of urobilinoid production to conventional values within 4-6 weeks [27]. It was demonstrated by Heimdahl and Nord that clindamycin strongly disturbs microbial colonization causing at least a 100-fold increase in indigenous facultative anaerobic flora [28]. The effect of antibiotics given orally for 6 days to healthy humans was investigated also in studies by Saxerholt et al and Midtvedt [16,17].…”

Section: Discussionmentioning

confidence: 94%

The impact of intestinal microflora on serum bilirubin levels

Vı́tek

Zelenka

Zadinová

et al. 2005

Journal of Hepatology

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“…Several studies have established the indiscriminate use of antimicrobials may cause a shift of oropharyngeal microbiota and favor colonization with gram-negative rods [7,8]. Such a shift is well established in patients with leukemia [9], but there are few published accounts highlighting such a shift in HIV-infected patients.…”

Section: Introductionmentioning

confidence: 99%

Oral Microflora: A Comparative Study in HIV and Normal Patients

Hegde

Kumar

Bhat

et al. 2011

Indian J Otolaryngol Head Neck Surg

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The study was designed to compare the oral microbiota in normal and HIV-infected individuals. The study tries to establish a significant shift in oral microflora in HIV-infected patients. Antibiotic sensitivity testing was performed to establish any rise in resistance against the antibiotics. It was a two and half year prospective study conducted in a tertiary care centre. The study group consisted of eighty subjects divided into two groups of control and HIV. The age range for this group was 9-75 years. The mean age in this group was 39.7 years. The male:female ratio was 2.75:1. Tuberculosis was the most common opportunistic infection in patients with HIV infection. The most common commensal micro organism isolated was the Viridans streptococci in 60% followed by Streptococcus pneumoniae in 23.33%. HIV Group: The most common commensal micro organism isolated was the Viridans streptococci in 42%; this was followed by the Micrococci spp. in 22% cases. S. pneumoniae was isolated in 6% of cases. The colony count for Viridans streptococci showed a heavy growth in 55.56% of cases in controls whereas the same in HIV group was 62.5%. Micrococcus spp. was isolated from 11 subjects in HIV group while it was not isolated from the controls. 50% subjects in the HIV group showed a heavy growth of Klebsiella spp. whereas controls showed only moderate and scanty growth. In patients with CD4? T cell count less than 50 cells/ll we found a heavy colonization of the oral cavity with Micrococcus spp., Acinetobacter and Klebsiella spp. Viridans streptococcus was not isolated in any of the patients with CD4? T cell count less than 50 cells/ll. As CD4? T cells counts improved to 51-100 cells/ll Viridans streptococcus colonies returned and 37.5% patients showed a heavy growth. Micrococcus spp. colonies were isolated till the CD4? T cells improved up to 300 cells/ll. At counts [ 300 cells/ll the oral microbiota became comparable to that of the controls. Many of the opportunistic infections in HIV are caused by commensal bacteria which are otherwise harmless in a normal individual. Our study is unique in that such a study of the oral commensals in HIV patients has never been reported. We found an increased colonization of the oral cavity by Micrococcus spp. which is a normal commensal of the skin.

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Effect of erythromycin and clindamycin on the indigenous human anaerobic flora and new colonization of the gastrointestinal tract

Cited by 55 publications

References 20 publications

Impact of dirithromycin on the normal oral and intestinal microflora

Impact of dirithromycin on the normal oral and intestinal microflora

The impact of intestinal microflora on serum bilirubin levels

Oral Microflora: A Comparative Study in HIV and Normal Patients

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