Prospective study of the impact of broad-spectrum antibiotics on the yeast flora of the human gut

Samonis, George; Gikas, Achilleas; Toloudis, P; Maraki, Sofia; Vrentzos, G.; Tselentis, Yannis; Tsaparas, N; Bodey, Gerald P.

doi:10.1007/bf01973996

Cited by 72 publications

(64 citation statements)

References 11 publications

(12 reference statements)

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“…Microorganisms with DS to the treatment received were selected in both groups of volunteers in all the ecosystems studied. In the feces, the increase in yeast counts was very important but did not differ between groups, although previously the emergence of yeast had been reported after treatment with amoxiclav (14,19,26) but not telithromycin (9). This may be due to differences in the selection of volunteers or in stool conservation methods.…”

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confidence: 80%

“…In each ecosystem, we focused on a specific microbiological species to analyze the ecological impact of treatments. In the feces, yeasts were chosen because their counts were reported to increase after amoxiclav treatment (14,19,26) but not after telithromycin treatment (9), and Clostridium difficile was chosen because of its role in antibiotic-associated intestinal side effects (3). Coagulase-negative staphylococci (CNS) and nongroupable streptococci (NGS) were chosen as target organisms in the cutaneous and pharyngeal flora because they can be the source of resistance in related pathogenic species such as Staphylococcus aureus (27) and Streptococcus pneumoniae (25), respectively, within these ecosystems.…”

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confidence: 99%

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Emergence of Resistance in Normal Human Aerobic Commensal Flora during Telithromycin and Amoxicillin-Clavulanic Acid Treatments

Crémieux

Müller-Serieys

Panhard

et al. 2003

Antimicrob Agents Chemother

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Mean fecal global yeast counts increased similarly during 7 days of treatment with telithromycin (800 mg once daily) or amoxicillin-clavulanic acid (amoxiclav) (1 g of amoxicillin and 125 mg of clavulanic acid 3 times daily) in human volunteers and decreased slowly thereafter. On skin, coagulase-negative staphylococci of decreased susceptibility (DS) to telithromycin increased in the telithromycin group, whereas those with DS to methicillin increased in the amoxiclav group. A similar antibiotic-related shift towards homologous DS was observed for oral nongroupable streptococci (NGS), but in addition, the prevalence of NGS resistant to both classes of antibiotics was significantly greater in the amoxiclav group at days 8 (P < 0.01) and 45 (P < 0.015).Antibiotics induce the emergence of resistant microorganisms in oropharyngeal, cutaneous, and intestinal bacteria and modify the competitive balance between organisms (for a recent review, see reference 23). Resistance in commensal bacteria can then be transferred to pathogenic species (7,8,13,18). Therefore, the emergence of resistance in the commensal flora can be included among the treatment-related adverse effects, but few studies (9, 11, 12) on this topic have been comparative between drugs which can be used alternately. Amoxicillin-clavulanic acid (amoxiclav) is an antibiotic widely used world-wide and well tolerated, except for intestinal side effects (17). Its impact on the intestinal (for a review, see reference 23), cutaneous (24), nasal (2, 4), and pharyngeal (11, 26) flora has been described. Telithromycin is a new ketolide antibiotic, designed for respiratory infections (14). It is well tolerated (1, 5) and seemed to have a favorable ecological profile in the oropharyngeal and intestinal microflora.(This work was presented in part at the 41st Interscience Conference on Antimicrobial Agents and Chemotherapy, Chicago, Ill., 16 to 19 December 2001.) Here, we compared the emergence of resistance in the commensal microflora of 2 groups of 25 fully informed healthy (by history, physical examination, routine laboratory tests, and electrocardiogram) adult (19 to 44 years) male volunteers, treated with either amoxiclav or telithromycin in a single-center, randomized, open-label, parallel-group comparative study. The volunteers had not taken antibiotics for 3 months and had a normal intestinal transit and a fecal count of enterobacteria greater than 10 4 CFU/g of feces at enrollment. They received either 2 tablets of 400 mg of telithromycin (Aventis Pharma, Paris, France) once daily for 7 days or 1 g of amoxicillin and 125 mg of clavulanic acid (GlaxoSmithKline, Paris, France) three times daily for 7 days. They were not hospitalized, but they returned to the center for all drug intakes and for follow-up visits (days 8, 14, 21, and 45). They were asked to continue their usual life and diet and allowed no other medication. Safety was evaluated at days 0 and 8, and adverse events were recorded by medical examination daily during treatment and then at days 14, 21, a...

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confidence: 80%

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confidence: 99%

Emergence of Resistance in Normal Human Aerobic Commensal Flora during Telithromycin and Amoxicillin-Clavulanic Acid Treatments

Crémieux

Müller-Serieys

Panhard

et al. 2003

Antimicrob Agents Chemother

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“…The administration of antimicrobial agents promotes the colonization of the GI tract by yeasts [5,6]. This effect depends on the antibacterial and pharmacodynamic properties of each particular agent [7,8].…”

Section: Discussionmentioning

confidence: 99%

“…In some patients, this phenomenon may cause disseminated fungal infection, most probably due to the penetration of GI mucosa by yeasts present in increased numbers [5,6].…”

Section: Introductionmentioning

confidence: 99%

Effect of Cefamandole, Cefuroxime and Cefoxitin on Yeast Fecal Flora of Surgical Patients

et al. 1998

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Aim of the present study was to evaluate the effect of cefamandole, cefuroxime and cefoxitin on the level of gastrointestinal (GI) colonization by Candida albicans in humans. Twenty-eight adult patients received one of these three cephalosporins for 10 days, as treatment of infection, and were studied prospectively. Quantitative stool cultures for yeasts were performed immediately before, at the end, and 1 week after discontinuation of treatment. All three antibiotics caused an increase of the yeast concentration in the fecal flora. The increase caused by cefoxitin was the highest (2.5 log₁₀ CFU/g of stool). Our results suggest that the cephalosporins tested cause minor increases of the colonization of the GI tract by C. albicans.

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“…gegenüber der bakteriellen Darmflora, zu einer Überwuche-rung des Darmes mit Hefen kommen, so dass die Candidazahlen über 10 5 KBE/g Stuhl ansteigen; außerdem setzt vermehrte Mycelbildung ein [84,101,106,107,110,111,112,113,114,115,116,117]. Zur Bedeutung der bakteriellen Flora s. Levy [105].…”

Section: Intestinale Candidabesiedelung Nach Antibiotikatherapieunclassified

Pathogenetische Bedeutung der intestinalen Candidabesiedelung

2004

Bundesgesundheitsbl - Gesundheitsforsch - Gesundheitsschutz

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Prospective study of the impact of broad-spectrum antibiotics on the yeast flora of the human gut

Cited by 72 publications

References 11 publications

Emergence of Resistance in Normal Human Aerobic Commensal Flora during Telithromycin and Amoxicillin-Clavulanic Acid Treatments

Emergence of Resistance in Normal Human Aerobic Commensal Flora during Telithromycin and Amoxicillin-Clavulanic Acid Treatments

Effect of Cefamandole, Cefuroxime and Cefoxitin on Yeast Fecal Flora of Surgical Patients

Pathogenetische Bedeutung der intestinalen Candidabesiedelung

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