Scevola D, Zambelli A, Concia E, Perversi L, Candiani C
Clin Ter. 1989 Apr 30;129(2):105-11.
The beneficial effect of disaccharides, lactulose and lactitol, in prevention and treatment of hepatic encephalopathy is well established but their use in combination with neomycin is still controversial. We studied in vitro the fecal bacterial growth, acid and gas formation in presence of lactitol (beta-galactoside-sorbitol) and neomycin alone or in combination. The results indicate that neomycin only inhibits the growth of susceptible bacteria (E. coli, Staph. aureus) which, conversely, are poor lactitol fermenters. The resistant organisms (Lactobacillus acidophilus, Clostridium perfringens) that are efficient disaccharide fermenters continue to metabolize lactitol still when antibiotic is added. Addition of lactitol 10% increased the inhibitory effect of neomycin on bacterial growth by 25-50% within 60-70 min. These preliminary data suggest that lactitol and neomycin may have additional or synergistic effects in vivo when used together in presence of favourable intestinal microbial environment.
双糖（乳果糖和乳糖醇）在预防和治疗肝性脑病方面的有益作用已得到充分证实，但它们与新霉素联合使用仍存在争议。我们在体外研究了单独或联合使用乳糖醇（β-半乳糖苷山梨醇）和新霉素时粪便细菌的生长、酸和气体的形成。结果表明，新霉素仅抑制易感细菌（大肠杆菌、金黄色葡萄球菌）的生长，而这些细菌相反是乳糖醇发酵能力较差的细菌。作为高效双糖发酵菌的耐药菌（嗜酸乳杆菌、产气荚膜梭菌）在添加抗生素后仍继续代谢乳糖醇。添加10%的乳糖醇在60 - 70分钟内使新霉素对细菌生长的抑制作用增加了25 - 50%。这些初步数据表明，在有利的肠道微生物环境下，乳糖醇和新霉素一起使用时在体内可能具有额外或协同作用。
