Effects of treatment with antimicrobial agents on the human colonic microflora

Rafii, Fatemeh

doi:10.2147/tcrm.s4328

Cited by 112 publications

(101 citation statements)

References 91 publications

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“…Another report found that trauma patients given prolonged (>48 h) prophylactic antibiotics were more likely to develop pneumonia with resistant or gram-negative bacteria [30]. Moreover, prolonged antibiotic regimens may alter the normal flora and phenotypes even without the selection of resistant organisms, potentially inducing normal flora to become pathogenic [31].…”

Section: Discussionmentioning

confidence: 99%

Antibiotic Use after Free Tissue Reconstruction of Head and Neck Defects: Short Course vs. Long Course

Khariwala

Pierce

et al. 2016

Surgical Infections

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Background: Free tissue reconstruction has become the standard of care for most major defects in the head and neck. Surgical site infection (SSI) can lead to vessel thrombosis and eventual flap loss. The use of antibiotics after free tissue reconstruction has not been studied in the current environment of heightened bacterial antibiotic resistance. We compared the use of short-term and longer-term antibiotics in a series of patients receiving free tissue reconstructions. Methods: A retrospective review was performed of 147 patients receiving 149 free flaps who were treated with either short-course (£2 d; n = 149 [43%]) or long-course (>2 d; n = 85 [57%])) post-operative antibiotics from 2009 to 2014. The outcomes examined were infection, return to the operating room, length of hospital stay, and patient death up to six weeks post-surgery. In addition, risk factors associated with SSI were explored. Results: Surgical site infection, flap dehiscence, flap loss, and length of stay were not different in the two groups. However, those receiving long-course antibiotics had a significantly higher rate of pneumonia (24.7% vs. 10.9%; p = 0.03), although they had a lower rate of urinary tract infection (0.0% vs 9.4%, respectively; p = 0.01). Body mass index remained a statistically significant risk factor in the multivariable analysis (p = 0.005). Conclusion: Prolonged antibiotic use after free flap reconstruction of head and neck defects does not appear to prevent SSI better than short-course treatment in this population. Moreover, long-course antibiotic use was associated with a higher risk of pneumonia.

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Section: Discussionmentioning

confidence: 99%

Antibiotic Use after Free Tissue Reconstruction of Head and Neck Defects: Short Course vs. Long Course

Khariwala

Pierce

et al. 2016

Surgical Infections

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“…Because of recurrent bronchopulmonary infections, patients with CF are treated with repeated courses of antibiotics. During antibiotic therapy, important bacterial groups may be radically reduced or eliminated from the gut, depending on the dosage of the antimicrobial agent and its pharmacokinetics (21,42,51). Although it is commonly accepted that the ecological balance is restored a few weeks after antibiotic administration, there is also evidence showing that antibiotic-associated disturbances can persist for a long period after treatment (25,27,49).…”

mentioning

confidence: 99%

“…Although it is commonly accepted that the ecological balance is restored a few weeks after antibiotic administration, there is also evidence showing that antibiotic-associated disturbances can persist for a long period after treatment (25,27,49). Furthermore, overgrowth by antibiotic-resistant bacteria and fungi may emerge from prolonged exposure to antimicrobial agents (51). In patients with CF, antibiotic-associated infections with opportunistic pathogens, such as Clostridium difficile, may cause severe diarrhea and/or pseudomembranous colitis (23,55).…”

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confidence: 99%

Cross-Sectional and Longitudinal Comparisons of the Predominant Fecal Microbiota Compositions of a Group of Pediatric Patients with Cystic Fibrosis and Their Healthy Siblings

Duytschaever

Huys

Bekaert

et al. 2011

Appl Environ Microbiol

105

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Although only poorly documented, it can be assumed that intensive antibiotic treatments of chronic lung infections in patients with cystic fibrosis (CF) also affect the diversity and metabolic functioning of the gastrointestinal microbiota and potentially lead to a state of dysbiosis. A better knowledge of the differences in gut microbiota composition and stability between patients with CF and healthy subjects could lead to optimization of current antibiotic therapies and/or development of add-on therapies. Using conventional culturing and population fingerprinting by denaturing gradient gel electrophoresis (DGGE) of 16S rRNA amplicons, we compared the predominant fecal microbiota of 21 patients with CF and 24 healthy siblings in a cross-sectional study. General medium counts, as well as counts on media specific for lactic acid bacteria, clostridia, Bifidobacterium spp., Veillonella spp., and Bacteroides-Prevotella spp., were consistently higher in sibling samples than in CF samples, whereas the reverse was found for enterobacterial counts. DGGE fingerprinting uncovered large intersubject variations in both study groups. On the other hand, the cross-sectional data indicated that the predominant fecal microbiota of patients and siblings had comparable species richness. In addition, a longitudinal study was performed on 7 or 8 consecutive samples collected over a 2-year period from two patients and their respective siblings. For these samples, DGGE profiling indicated an overall trend toward lower temporal stability and lower species richness in the predominant fecal CF microbiota. The observed compositional and dynamic perturbations provide the first evidence of a general dysbiosis in children with CF compared to their siblings.

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“…This suggests that the increased spectrum of activity can have severe consequential side effects through disruption of the normal gastrointestinal flora, manifesting is a rather morbid fashion through increased state obesity rates. The increased collateral damage on GI flora brought on by a course of broad-spectrum antibiotics has been noted in multiple studies, while failing to find the same effect from narrow-spectrum antibiotic use [94][95][96].…”

Section: Discussion/conclusionmentioning

confidence: 99%

Broad-Spectrum Antibiotic Abuse and its Connection to Obesity

Czaja¹

2017

JNHFS

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The purpose of this review was to assess patterns of antibiotic prescriptions across the United States and evaluate their relationship with associated conditions. A focus on national antibiotic prescriptions and proposed side effects was studied from 1993-2008. State-to-state differences in antibiotic prescribing and associated patterns of obesity were studied from 2011-2014. Data for these study periods was extracted from the CDC and affiliated institutions. Correlation assessments between antibiotic prescription patterns and a set of variables related to the proposed mechanism of antibiotic effects were made. From 2011-2014, cephalosporin prescriptions demonstrated the strongest relationship with associated obesity rates, while beta-lactams (cephalosporins and penicillins) showed weaker relationships when taken as a holistic class. To make light of these results, drug use of Ceftriaxone, a broad-spectrum, third-generation cephalosporin and Amoxicillin, a narrow-spectrum penicillin, was compared from 1993 to 2008 in relation to the prevalence of various health conditions: obesity; diabetes mellitus; sleep disorders; endocrine, nutritional, metabolic diseases and immunity disorders; and infectious and parasitic diseases. Ceftriaxone demonstrated a strong, significant, and positive relationship with all of the above variables, except for parasitic and infectious diseases. By comparison, Amoxicillin showed weak and non-significant relationships with all of the above variables. Despite their correlational limitations, these results suggest that broad-spectrum antibiotics play a significant role in the development and persistence of many chronic conditions in the United States. A mechanism providing a hypothesized explanation for these results was proposed based on extensive literature review.

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Effects of treatment with antimicrobial agents on the human colonic microflora

Cited by 112 publications

References 91 publications

Antibiotic Use after Free Tissue Reconstruction of Head and Neck Defects: Short Course vs. Long Course

Antibiotic Use after Free Tissue Reconstruction of Head and Neck Defects: Short Course vs. Long Course

Cross-Sectional and Longitudinal Comparisons of the Predominant Fecal Microbiota Compositions of a Group of Pediatric Patients with Cystic Fibrosis and Their Healthy Siblings

Broad-Spectrum Antibiotic Abuse and its Connection to Obesity

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