The screening of four aminoglycosides in the selective decontamination of the digestive tract in mice

Abstract

The suppressive effect of amikacin, gentamicin, tobramycin and paromomycin on the aerobic endogenous flora and on the colonization resistance of the digestive tract was tested by administering one of the antibiotics orally at five different dose levels. At a certain dose level, all antibiotics suppressed the endogenous Enterobacteriaceae species. Amikacin was particularly effective in this respect. Low doses of amikacin rapidly destroyed the colonization resistance. This resistance only remained unaffected in animals treated with tobramycin in doses that were still adequate to completely suppress the endogenous Enterobacteriaceae species. We concluded that of all the antibiotics tested in this study, only tobramycin may have a future in (clinical) application for the selective decontamination of the digestive tract. Selective decontamination can be considered an effective method for infection prevention in leukopenic patients.

Binding to and antibacterial effect of aztreonam, temocillin, gentamicin and tobramycin on human faeces

“…The SD factors of aztreonam and tobramycin meet this criterion and may therefore be used for SD. The usefulness of tobramycin for SD is in line with results of van der Waaij et al (1982), who showed that tobramycin could be used for SD of mice in contrast to gentamicin. Another study by this group (de Vries-Hospers et al 1984) showed that the administration of aztreonam (300 mg/day) to 10 healthy subjects resulted in the elimination of the Enterobacteriaceae in 8 persons.…”

“…In this respect non-absorbable antibiotics are of special interest because they will reach the large bowel. In animal studies (Emmelot & van der van der Waaij et al 1982;Hazenberg et al 1983a) as well as in clinical trials (Sleijfer et al 1980; Vries-Hospers et al 1981; Guiot, van der Meer & van Furth, 1981;Guiot et al 1983;Kurrle et al 1983) low doses ofneomycin and particularly polymyxin B proved to be very useful. In vitro studies on the human intestinal flora showed that the selective effect was associated with a relative insusceptibility of the obligately anaerobic flora as compared with the Gram-negative facultatively anaerobic rods (Hazenberg et al 1983b(Hazenberg et al , 1984.…”

Selective Decontamination of the Digestive Tract in Surgical Patients

“…25 These antibiotics have limited activity against the normal anaerobic flora and maintain normal colonization resistance. 26 In addition, intravenous cefotaxime sodium is administered until surveillance cultures demonstrate adequate decontamination of the GI tract, generally 4 days following the initiation of SDD. Cefotaxime treats early established infection by community-acquired pathogens, particularly Streptococcus pneumoniae or Haemophilus influenzae, that may be aspirated during intubation, and temporizes until the enterally administered antibiotics have adequately decontaminated the GI tract.…”

Protective role of intestinal flora against infection with Pseudomonas aeruginosa in mice: influence of antibiotics on colonization resistance

“…Several studies have shown that the phenomenon of overgrowth by opportunistic bacteria occurs in mice as well as in humans that have been treated with antimicrobial agents (2,3,5,6,9,23). Although there are differences in flora composition between humans and mice, mice have been used in these studies because of the similarity in response of their protective flora and that of humans to antimicrobial agents (21). Reports of van der Waaij et al (22,23) emphasize a critical role for anaerobic bacteria in the maintenance of colonization resistance in the intestinal tracts of mice.…”