Influence of peroral antibiotics upon the biotransformatory activity of the intestinal microflora in healthy subjects.

The effects of ampicillin, clindamycin or metronidazole, given perorally for 6 days to eighteen healthy volunteers, upon the following intestinal microflora-associated characteristics (MACs) were evaluated: breakdown of mucin, formation of coprostanol, hydrolysis of bilirubin conjugates, formation of urobilinogen, and of some short chain fatty acids (SCFAs), presence of beta-aspartylglycine and inactivation of trypsin. Clindamycin markedly influenced the expression of all characteristics, but trypsin and beta-aspartylglycine, resulting in a pattern very much alike what has been found in germ-free animals. Ampicillin caused a significant reduction in total amount of SCFAs (P less than 0.05) and urobilinogen (P less than 0.05) present in the faecal samples. Metronidazole caused a significant reduction in the formation of coprostanol and the deconjugation of bilirubin (P less than 0.05). We conclude that orally given antibiotics may cause major alterations in several parameters reflecting the normal biotransformatory activity of the intestinal microflora, probably caused by severe disturbances in the intestinal ecosystem.