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Betalactam therapy and intestinal flora
A Novelli1, T Mazzei, S Fallani
1Dipartimento di Farmacologia, Università degli Studi di Firenze, Italy.
Journal of Chemotherapy (Florence, Italy)
|May 1, 1995
Summary
Oral cephalosporins like cefixime and cefuroxime axetil significantly alter gut bacteria. Cefetamet-pivoxil minimally impacts intestinal flora, suggesting fewer gastrointestinal side effects.
Area of Science:
- Microbiology
- Pharmacology
- Gastroenterology
Background:
- Oral betalactam antibiotics can modify intestinal flora due to absorption and activity spectrum.
- Investigating the impact of new oral cephalosporins on human gut microflora is crucial.
Purpose of the Study:
- To assess the influence of cefetamet-pivoxil (CET), cefixime (CFX), and cefuroxime axetil (CA) on normal human intestinal flora.
- To compare the effects of these oral cephalosporins on gut microflora composition.
Main Methods:
- A 10-day course of CET (500 mg BID), CFX (400 mg QD), or CA (250 mg BID) was administered to 24 patients with chronic bronchitis exacerbation.
- Stool specimens were collected pre-treatment, post-treatment (day 10), and post-treatment (day 24).
- Quali-quantitative microflora composition was analyzed.
Main Results:
- CET treatment resulted in minor, non-significant changes in intestinal flora.
- CFX and CA significantly affected Enterobacteriaceae and clostridia, with a rise in enterococci for CFX.
- Salmonella spp. and Clostridium difficile emerged in patients treated with CFX and CA.
Conclusions:
- Cefetamet-pivoxil demonstrates minimal impact on normal bowel flora compared to other oral cephalosporins.
- This limited effect may correlate with a lower incidence of gastrointestinal side effects for CET.
- Oral cephalosporins vary in their effects on gut microbiota, influencing clinical tolerability.