Effect of ofloxacin on oral and gastrointestinal microflora in patients undergoing gastric surgery

Abstract

The effect of ofloxacin on the microflora in saliva, gastric juice, and feces was evaluated in 24 patients undergoing gastric surgery. A single peroral dose of 400 mg ofloxacin was given to each patient 2-4 h before surgery. The concentrations of ofloxacin in serum, saliva, gastric juice, and gastric mucosa tissue were assayed. Only Branhamella cocci were affected in the saliva. In the gastric juice, both the aerobic and anaerobic flora were suppressed on the day of surgery, but increased in number afterwards. There was a significant correlation between gastric pH and the number of microorganisms isolated in the gastric juice on day 0. In faeces, the aerobic and part of the anaerobic flora were suppressed by the administration of ofloxacin. Ofloxacin was well tolerated by the patients. Four of 24 patients developed postoperative complications. Microorganisms isolated from wound sepsis and intraabdominal sepsis (three patients) were Staphylococcus epidermidis, Staphylococcus aureus, hemolytic streptococci group A, Streptococcus sp. and Escherichia coli. All related infections occurred in patients with very low ofloxacin serum concentrations, probably due to impaired absorption. Oral antibiotic prophylaxis is not recommended in patients in whom impaired gastric emptying can be expected.

Impact of Fluoroquinolones on Human Microbiota. Focus on the Emergence of Antibiotic Resistance

“…Concerning the gut microbiota, the most striking fact is the total elimination of FQ-susceptible enterobacteria, which are not detectable by conventional culture methods during treatment (Table 2). This phenomenon is found regardless of the FQ used [13,15,17,37,40,[44][45][46]49]. Although FQ may bind to feces [22,35], assuming that only 1% of the fecal concentration of FQs is unbound and therefore fully active, the MIC values for susceptible enterobacteria would still be exceeded, explaining their suppression in vivo.…”

“…Focus on the emergence of antibiotic resistance review future science group www.futuremedicine.com bacterial species, according to the European Committee of Antimicrobial Susceptibility Testing (EUCAST), which are summarized in Table 1 [36]. Studies in humans looking at drug concentrations in microbial ecosystems have been performed mostly during Phase I and Phase III clinical trials and have focused on the fecal excretion [13,14,[37][38][39][40][41]. More recent studies analyzing the ecological disturbances related to FQ therapy also provide us interesting data on FQ concentrations in saliva, sweat and nasal secretions [15][16][17]42,43].…”

Effects of treatment with antimicrobial agents on the human colonic microflora

“…By administration of different fluoroquinolones and enumeration of bacteria from different genera before and after exposure, it was shown that fluoroquinolones have a selective effect on the normal colonic bacteria. The effects of ciprofloxacin (Brismar et al 1990), norfloxacin (Edlund et al 1987a, 1987b; Edlund and Nord 1988a), ofloxacin (Pecquet et al 1987; Edlund et al 1988), pefloxacin (Vollaard et al 1992), lomefloxacin (Edlund et al 1990), levofloxacin (Edlund et al 1997b), sparfloxacin (Ritz et al 1994), rufloxacin (D’Antonio et al 1996), sitafloxacin (Inagaki and Yamamoto et al 1995), gatifloxacin (Edlund and Nord 1999a), trovafloxacin (Edlund and Nord 1999b), and moxifloxacin (Edlund and Nord 1999b; Edlund et al 2000b) on the intestinal microflora have been analyzed. All of the fluoroquinolones tested decreased the populations of enterobacteria, and pefloxacin decreased the number of aerobic Gram-positive cocci.…”

The impact of rufloxacin given as prophylaxis to patients with cancer on their oral and faecal microflora

“…declined significantly in 25% of the cases. This might have been caused by an increase in the oxygen concentration in the gut as a result of the reduction in faecal aerobes (Edlund et al, 1988). This effect upon these anaerobes appears to be a characteristic feature of the newer fluoroquinolones and has been noted after a single dose of 400 mg rufloxacin (Marco et al, 1995).…”