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The effect of antimicrobial agents on fecal flora of children
Abstract:
Influences of antibiotics on the fecal flora in children were studied for oral ampicillin, penicillin V, erythromycin, cefaclor, and gentamicin and for intravenous ampicillin, methicillin, cefpiramide, and ceftazidime. All antibiotics affected the normal flora, although the quality and quantity of the changes were variable. No substantial differences were noted between the oral and intravenous use of ampicillin with regard to its effect on the flora. Three penicillins, ampicillin, penicillin V, and methicillin, caused remarkable changes. The characteristic pattern observed was the considerable suppression of Bifidobacterium, Streptococcus, and Lactobacillus species. Although enterobacteria did not significantly change in number, Klebsiella spp. frequently replaced Escherichia coli. In patients given erythromycin and cefaclor, the reduction in the number of Bifidobacterium spp. was 1 log10 and that of members of the family Enterobacteriaceae was 3 log10. Gentamicin administered orally caused a drastic change, including a remarkable decline of E. coli to less than 2 log10/g of feces. Cefpiramide, a parenteral expanded-spectrum cephalosporin, suppressed normal flora so markedly that almost all species of organisms were eradicated, and the active growth of yeasts was promoted (2.6 log10 increase). Ceftazidime caused similar changes as cefpiramide, but the changes were less extensive. Yeasts increased after treatment with most antibiotic groups. This increase was particularly prominent in patients given oral penicillins and expanded-spectrum cephalosporins.
Insights
Antibiotics significantly alter children's fecal flora, with penicillins suppressing key beneficial bacteria. Broad-spectrum cephalosporins and gentamicin cause drastic changes, often promoting yeast overgrowth.
Area of Science:
- Microbiology
- Pediatric Medicine
- Pharmacology
Background:
- Antibiotic use in children can disrupt the delicate balance of the gut microbiome.
- Understanding the impact of different antibiotic classes on fecal flora is crucial for pediatric health.
- Previous studies have shown variable effects of antibiotics on gut microbiota composition.
Purpose of the Study:
- To investigate the influence of various oral and intravenous antibiotics on the fecal flora of children.
- To compare the effects of different antibiotic classes, including penicillins, cephalosporins, macrolides, and aminoglycosides.
- To document specific changes in bacterial populations and yeast presence following antibiotic administration.
Main Methods:
- Children received oral ampicillin, penicillin V, erythromycin, cefaclor, gentamicin, or intravenous ampicillin, methicillin, cefpiramide, ceftazidime.
- Fecal samples were analyzed to assess changes in bacterial flora composition and quantity.
- Quantitative analysis of specific bacterial genera (e.g., Bifidobacterium, Streptococcus, Lactobacillus, Enterobacteriaceae, E. coli) and yeast was performed.
Main Results:
- All tested antibiotics altered fecal flora, with variable qualitative and quantitative changes.
- Oral and intravenous ampicillin showed similar effects on the flora.
- Penicillins (ampicillin, penicillin V, methicillin) significantly suppressed Bifidobacterium, Streptococcus, and Lactobacillus species.
- Enterobacteria numbers were largely unchanged, but Klebsiella spp. often replaced Escherichia coli.
- Erythromycin and cefaclor reduced Bifidobacterium (1 log10) and Enterobacteriaceae (3 log10).
- Oral gentamicin drastically reduced E. coli (<2 log10/g).
- Cefpiramide and ceftazidime markedly suppressed normal flora, promoting significant yeast growth (up to 2.6 log10 increase).
- Yeast proliferation was observed with most antibiotic groups, especially oral penicillins and expanded-spectrum cephalosporins.
Conclusions:
- Antibiotic administration in children leads to significant, albeit variable, disruptions in fecal microbiota.
- Specific antibiotic classes exhibit distinct patterns of microbial suppression and overgrowth, notably affecting beneficial bacteria and promoting yeasts.
- The findings highlight the need for careful antibiotic selection in pediatric populations to minimize long-term microbiome disturbances.