INTRODUCTIONThe actual interest in probiotics is also determined by the intestinal side effects of antibiotics and increased resistance of intestinal bacteria.AIMWe studied the effects of different commercial preparations of probiotics on the intestinal ecosystem during ceftriaxone administration in children to correct microflora imbalance.METHODSFifty-one children (age 4-10 years) with respiratory tract infections were subdivided in eight groups and treated with ceftriaxone (1g/d) along with six different probiotic preparations (Lactobacillus, Bifidobacterium, Enterococcus, Saccharomyces) or lactulose for a week. The activity of betalactamases and other enzymes, flora composition, and ceftriaxone concentrations were determined in faeces before and after treatment.RESULTSCeftriaxone caused a E.coli count decrease and enterococci increase. The administration of all probiotics along with ceftriaxone maintained the inhibition of E.coli, while the increase in enterococci was partially normalised. The effects on the other bacterial components showed more or less appreciable differences according to probiotic administered. The mean count of microaerophilic lactobacilli increased slightly, while different species of lactobacilli and bifidobacteria were isolated more frequently. Reduction in number of species of clostridia (from 6 to 3 different species) after therapy was observed. No C.difficile was detected in all children. The increase in lactobacilli and anaerobic gram-positive fermentative species contributed to maintain a low faecal pH (slight decrease of pH from 6.9 to 6.6). Bowel movements/day were reduced in probiotic treated children. Faecal beta-lactamase activity increased during antimicrobial therapy. In the probiotic treated groups the incidence was lower (25% - 30%). This is an unespected effect of bacterial strains selected for probiotic use.CONCLUSIONSProbiotics administered along with ceftriaxone at the start of antimicrobial therapy contribute to ameliorate the intestinal dysbiosis. Probiotics administration could afford protection against beta-lactamases production or activity. Their potential for resistance reduction in these conditions should be confirmed by further studies.
CEFTRIAXONE THERAPY, INTESTINAL BETA-LACTAMASES AND INTERACTION WITH PROBIOTICS IN CHILDREN
BENINI, Anna;BERTAZZONI MINELLI, Elisa
2012-01-01
Abstract
INTRODUCTIONThe actual interest in probiotics is also determined by the intestinal side effects of antibiotics and increased resistance of intestinal bacteria.AIMWe studied the effects of different commercial preparations of probiotics on the intestinal ecosystem during ceftriaxone administration in children to correct microflora imbalance.METHODSFifty-one children (age 4-10 years) with respiratory tract infections were subdivided in eight groups and treated with ceftriaxone (1g/d) along with six different probiotic preparations (Lactobacillus, Bifidobacterium, Enterococcus, Saccharomyces) or lactulose for a week. The activity of betalactamases and other enzymes, flora composition, and ceftriaxone concentrations were determined in faeces before and after treatment.RESULTSCeftriaxone caused a E.coli count decrease and enterococci increase. The administration of all probiotics along with ceftriaxone maintained the inhibition of E.coli, while the increase in enterococci was partially normalised. The effects on the other bacterial components showed more or less appreciable differences according to probiotic administered. The mean count of microaerophilic lactobacilli increased slightly, while different species of lactobacilli and bifidobacteria were isolated more frequently. Reduction in number of species of clostridia (from 6 to 3 different species) after therapy was observed. No C.difficile was detected in all children. The increase in lactobacilli and anaerobic gram-positive fermentative species contributed to maintain a low faecal pH (slight decrease of pH from 6.9 to 6.6). Bowel movements/day were reduced in probiotic treated children. Faecal beta-lactamase activity increased during antimicrobial therapy. In the probiotic treated groups the incidence was lower (25% - 30%). This is an unespected effect of bacterial strains selected for probiotic use.CONCLUSIONSProbiotics administered along with ceftriaxone at the start of antimicrobial therapy contribute to ameliorate the intestinal dysbiosis. Probiotics administration could afford protection against beta-lactamases production or activity. Their potential for resistance reduction in these conditions should be confirmed by further studies.
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