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Impact of cefotaxime on the fecal flora in children
Insights
Cefotaxime treatment in children reduced E. coli in fecal flora but increased Pseudomonas. This impacts understanding of gut-origin septicemia risks and antibiotic effects on pediatric microbial communities.
Area of Science:
- Microbiology
- Pediatric Medicine
- Pharmacology
Background:
- Fecal flora stability is crucial for preventing intestinal origin septicemia, especially in newborns.
- Antibiotic use can significantly alter gut microbial composition.
- Understanding these alterations is key for managing pediatric infections.
Purpose of the Study:
- To investigate the impact of cefotaxime on fecal flora in hospitalized children.
- To compare cefotaxime's effects against a stable control group.
- To assess the implications for septicemia risk.
Main Methods:
- Differential quantitative analysis of fecal specimens from 26 children treated with cefotaxime.
- Comparison with a control group of 41 children without antibiotic treatment.
- Collection of samples before, during, and after cefotaxime therapy.
Main Results:
- Cefotaxime decreased or eliminated E. coli in 65% of treated children.
- A slight decrease in Klebsiella and Enterobacter was observed.
- Pseudomonas species emerged in 12 out of 26 children, including Pseudomonas aeruginosa.
Conclusions:
- Cefotaxime significantly alters pediatric fecal flora, reducing key bacteria like E. coli.
- The emergence of Pseudomonas warrants attention due to potential health implications.
- Findings are relevant for managing secondary septicemia and understanding antibiotic-induced microbial shifts.
Abstract:
A differential quantitative analysis was used to study the effect of cefotaxime on the fecal flora in 26 hospitalized children ranging from two days to four years of age. Fecal specimens were obtained before, during and after therapy. This study was evaluated in comparison to 41 patients of the same age and from the same environment without antibiotic treatment or signs of infection. The fecal flora of the control group showed qualitative and quantitative stability. Two groups of species were distinguished: a group in which the upper limit was less than or equal to 10(7) bacteria/g of stool (Klebsiella, Enterobacter, other enterobacteria, Staphylococcus, Pseudomonas) and a group with less than or equal to 10(10) bacteria/g of stool (anaerobes, Escherichia coli, Streptococcus D). This stability of the control group of subjects allowed us to interpret the variations of microbial concentrations during and after cefotaxime treatment. In previous studies, we showed in the newborn a substantial risk of septicemia of intestinal origin when overgrowth occurred, especially with Klebsiella. With cefotaxime there was a decrease or a disappearance in 65% of E. coli and a slight decrease of Klebsiella and Enterobacter. This fact was of great interest in the treatment of endogenous secondary septicemia. We observed an appearance of Pseudomonas (nine Pseudomonas aeruginosa, two Pseudomonas putida, one Pseudomonas fluorescens) in 12 cases among the 26 children treated.(ABSTRACT TRUNCATED AT 250 WORDS)