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Influence of third-generation cephalosporins on aerobic intestinal flora
Abstract:
Excretion of an antibiotic in bile may result in high intra-intestinal concentrations and thus alteration in the faecal flora. We investigated the effects of cefoperazone (75% biliary excretion), ceftriaxone (45%) and cefotaxime (5%) on the aerobic faecal flora. Cefoperazone reduced numbers of normal Gram-negative bacilli and selected resistant Pseudomonas, Serratia and Klebsiella-Enterobacter. Ceftriaxone was similar. However, cefotaxime had little effect on the normal Gram-negative flora, and did not promote the emergence of resistant organisms.
Insights
High biliary excretion of antibiotics like cefoperazone and ceftriaxone alters gut flora, promoting resistant bacteria. Cefotaxime, with low biliary excretion, showed minimal impact on fecal flora and resistance.
Area of Science:
- Microbiology
- Pharmacology
- Gastroenterology
Background:
- Antibiotic excretion into bile can lead to high concentrations within the gastrointestinal tract.
- This can significantly alter the composition and function of the fecal flora.
- Understanding these effects is crucial for managing antibiotic use and preventing resistance.
Purpose of the Study:
- To investigate the impact of three cephalosporin antibiotics with varying biliary excretion rates on aerobic fecal flora.
- To compare the effects of cefoperazone, ceftriaxone, and cefotaxime on the gut microbiome and the emergence of resistant bacteria.
Main Methods:
- Analysis of aerobic fecal flora composition.
- Administration of cefoperazone (75% biliary excretion), ceftriaxone (45% biliary excretion), and cefotaxime (5% biliary excretion).
- Monitoring changes in bacterial populations, including Gram-negative bacilli and the selection of resistant strains.
Main Results:
- Cefoperazone and ceftriaxone significantly reduced normal Gram-negative bacilli populations.
- These antibiotics also selected for resistant strains of Pseudomonas, Serratia, and Klebsiella-Enterobacter.
- Cefotaxime demonstrated minimal disruption to the normal Gram-negative flora and did not promote the emergence of resistant organisms.
Conclusions:
- Antibiotic biliary excretion levels correlate with their impact on fecal flora.
- High biliary excretion antibiotics (cefoperazone, ceftriaxone) disrupt the gut microbiome and foster antibiotic resistance.
- Cefotaxime, due to its low biliary excretion, is a safer option regarding fecal flora alteration and resistance development.