Bhatnagar S, Bhan M K, Sazawal S, Gupta U, George C, Arora N K, Kashyap D K
Department of Pediatrics, All India Institute of Medical Sciences, New Delhi.
J Pediatr Gastroenterol Nutr. 1992 Aug;15(2):117-24. doi: 10.1097/00005176-199208000-00003.
Overgrowth of aerobic and anaerobic bacteria in the upper small intestine is a common finding in persistent diarrhea. We hypothesized that a large dose of broad spectrum, nonabsorbable oral antibiotic would hasten recovery from persistent diarrhea by eradicating aerobic bacterial overgrowth. Sixty-eight patients were randomly assigned to treatment with either oral gentamicin (n = 33) or placebo (n = 35) for a period of 6 days. The two groups were comparable in their clinical features, stool weights, duodenal and fecal microflora, during an initial 24 h observation period before randomization. The proportion of patients recovering within 6 days post-treatment was similar in the antibiotic (45.2%) and placebo (50%) groups. The stool weights in the two groups during 24-72, 72-120, and 120-168 h of the study did not differ significantly. The percent mean weight gain (g) at 168 h post-treatment in the antibiotic (1.0 +/- 5.1) and placebo (1.4 +/- 5.3) groups also did not differ significantly (p = 0.8). A similar proportion of antibiotic- (61.3%) and placebo- (60.7%) treated patients had started to gain weight by the last day of the study. We conclude that oral gentamicin was no more effective than placebo in reducing purge rates, in achieving earlier recovery from diarrhea, and in promoting the earlier onset of weight gain in this study.
小肠上段需氧菌和厌氧菌过度生长是持续性腹泻的常见表现。我们推测，大剂量广谱、不可吸收的口服抗生素通过根除需氧菌过度生长可加速持续性腹泻的恢复。68例患者被随机分为口服庆大霉素组（n = 33）或安慰剂组（n = 35），治疗6天。在随机分组前的初始24小时观察期内，两组患者的临床特征、粪便重量、十二指肠和粪便微生物群具有可比性。治疗后6天内康复的患者比例在抗生素组（45.2%）和安慰剂组（50%）中相似。在研究的24 - 72小时、72 - 120小时和120 - 168小时期间，两组的粪便重量无显著差异。治疗后168小时抗生素组（1.0 +/- 5.1）和安慰剂组（1.4 +/- 5.3）的平均体重增加百分比（g）也无显著差异（p = 0.8）。在研究的最后一天，接受抗生素治疗（61.3%）和安慰剂治疗（60.7%）的患者中体重开始增加的比例相似。我们得出结论，在本研究中，口服庆大霉素在降低腹泻率、实现腹泻更早恢复以及促进体重更早增加方面并不比安慰剂更有效。
