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[Selective decontamination of intestinal flora with oral aztreonam in compromised children]
Insights
Oral aztreonam significantly altered fecal flora in immunocompromised children, decreasing enterobacteria and bifidobacteria while increasing streptococci. This suggests potential for selective intestinal decontamination in vulnerable patients.
Area of Science:
- Microbiology
- Pediatric Medicine
- Pharmacology
Context:
- The gut microbiome plays a crucial role in the health of immunocompromised individuals.
- Altering the gut flora can have significant implications for infection risk and overall patient outcomes.
- Understanding the impact of antibiotics on fecal flora is essential for optimizing treatment strategies.
Purpose:
- To investigate the effects of oral aztreonam on the composition of fecal microbiota in pediatric patients with compromised immune systems.
- To quantify changes in specific bacterial groups, including enterobacteria, bifidobacteria, and streptococci, during and after aztreonam treatment.
Summary:
- Oral aztreonam administration (10-30 mg/kg/day) in 6 immunocompromised children (ages 4-14) led to significant reductions in enterobacteria (10^7.7 to 10^4.4/g) and bifidobacteria (10^10.2 to 10^8.4/g).
- Concurrently, a substantial increase in streptococci counts (10^2.9 to 10^9.4/g) was observed during aztreonam treatment.
- No significant alterations were noted in other anaerobic organisms.
Impact:
- The findings suggest that oral aztreonam may serve as a valuable tool for selective decontamination of the intestinal flora in immunocompromised hosts.
- This selective decontamination could potentially reduce the risk of opportunistic infections in vulnerable pediatric populations.
- Further research is warranted to explore the long-term clinical benefits and safety of this approach.
Abstract:
Effects of oral aztreonam on fecal flora were studied in 6 compromised children. Their ages ranged from 4 to 14 years. Daily doses of aztreonam were 10 to 30 mg/kg. The stool specimens were obtained before the treatment, on day 5 to 7 of aztreonam use and 2 to 5 days after the cessation of treatment. The counts of enterobacteria decreased from 10(7.7) to 10(4.4) per gram of wet feces (p less than 0.01), and bifidobacteria also decreased from 10(10.2) to 10(8.4) per gram of wet feces (p less than 0.01) during aztreonam administration. Those of streptococci increased from 10(2.9) to 10(9.4) per gram of wet feces (p less than 0.001). The other anaerobic organisms showed no marked change. Based upon the above results, we conclude that oral administration of aztreonam may be useful for selective decontamination of intestinal flora in compromised hosts.