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Changes in periurethral microflora after antimicrobial drugs
K J Lidefelt1, I Bollgren, C E Nord
1Department of Paediatrics, Karolinska Institute, Sachs' Children's Hospital, Stockholm, Sweden.
Archives of Disease in Childhood
|June 1, 1991
Summary
Antibiotic treatment for respiratory infections can alter the periurethral flora in girls. Amoxicillin reduced beneficial anaerobic bacteria, allowing harmful enterobacteria to colonize, potentially increasing urinary tract infection risk.
Area of Science:
- Microbiology
- Infectious Diseases
- Pharmacology
Background:
- The periurethral flora plays a crucial role in preventing urinary tract infections (UTIs).
- Antibiotic use for common infections may impact this protective microflora.
Purpose of the Study:
- To investigate the effects of amoxicillin and trimethoprim-sulfamethoxazole on the periurethral flora in girls.
- To explore the potential link between antibiotic-induced flora changes and UTI pathogenesis.
Main Methods:
- Quantitative sampling of periurethral flora in 18 girls before, during, and after antibiotic treatment.
- Analysis of changes in anaerobic and aerobic bacterial counts and species diversity.
- Comparison of effects between amoxicillin and trimethoprim-sulfamethoxazole treatments.
Main Results:
- Amoxicillin treatment led to a reduction in anaerobic flora and overgrowth of enterobacteria in 5 out of 8 girls.
- Trimethoprim-sulfamethoxazole did not significantly affect the anaerobic flora or cause enterobacterial overgrowth.
- Periurethral flora composition returned to baseline three weeks post-amoxicillin treatment.
Conclusions:
- Amoxicillin may disrupt the protective periurethral anaerobic microflora.
- This disruption could promote enterobacterial colonization, potentially contributing to UTI development.
- Antibiotics might be a contributing factor in the pathogenesis of urinary tract infections.