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Effect of piperacillin/tazobactam therapy on intestinal microflora
C E Nord1, B Brismar, B Kasholm-Tengve
1Department of Microbiology, Huddinge University Hospital, Sweden.
Abstract:
The effect of piperacillin/tazobactam treatment upon the intestinal microflora was studied in 20 patients with intraabdominal infections. The patients received piperacillin 4 g combined with tazobactam 500 mg q 8 h by intravenous injection for 4-8 days. Stool specimens were collected before, during and after therapy for cultivation of aerobic and anaerobic microorganisms. Six patients had measurable concentrations of piperacillin (1.2-276 mg/kg/faeces) and 4 patients tazobactam concentrations (0.8-22.2 mg/kg/faeces) in the faecal specimens during therapy. The number of enterobacteria and enterococci slightly decreased while there were no changes in the number of staphylococci and bacilli. The anaerobic microflora was also slightly affected. There was a minor decrease in the number of bifidobacteria, eubacteria, lactobacilli, clostridia and veillonella but the numbers of anaerobic Gram-positive cocci and bacteroides were not influenced by the treatment. After therapy, the aerobic and anaerobic microflora returned to normal levels in all patients. None of the patients had Clostridium difficile or cytotoxin in the stools or developed diarrhoea.
Insights
Piperacillin/tazobactam treatment minimally impacted intestinal microflora in patients with intra-abdominal infections. Gut bacteria returned to normal levels post-treatment, with no cases of diarrhea or Clostridium difficile.
Area of Science:
- Microbiology
- Pharmacology
- Gastroenterology
Background:
- Intra-abdominal infections often necessitate broad-spectrum antibiotic therapy.
- Understanding the impact of antibiotics like piperacillin/tazobactam on gut microbiota is crucial for patient management.
Purpose of the Study:
- To evaluate the effects of piperacillin/tazobactam on the intestinal microflora in patients with intra-abdominal infections.
- To assess the recovery of gut microbiota after the antibiotic treatment.
Main Methods:
- Twenty patients with intra-abdominal infections received piperacillin/tazobactam intravenously for 4-8 days.
- Stool specimens were collected pre-therapy, during therapy, and post-therapy.
- Aerobic and anaerobic microorganisms were cultivated to assess changes in microflora composition.
Main Results:
- A slight decrease in enterobacteria and enterococci was observed; staphylococci and bacilli counts remained unchanged.
- Anaerobic microflora showed minor reductions in bifidobacteria, eubacteria, lactobacilli, clostridia, and veillonella.
- Microflora composition, including anaerobic Gram-positive cocci and bacteroides, was largely unaffected.
- Intestinal microflora returned to baseline levels in all patients after treatment completion.
Conclusions:
- Piperacillin/tazobactam exhibited a minimal and transient effect on the intestinal microflora.
- The gut microbiota demonstrated resilience and recovered effectively following treatment.
- No adverse gastrointestinal events, such as diarrhea or Clostridium difficile infection, were reported.