Vollaard E J, Clasener H A, van Griethuysen A J, Janssen A J, Sanders-Reijmers A H, Muller N F, Huige P J
Department of Pharmacy, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands.
J Antimicrob Chemother. 1988 Nov;22(5):747-58. doi: 10.1093/jac/22.5.747.
The influence of oral administration of cefaclor, phenethicillin, co-trimoxazole and doxycycline on colonization resistance (CR) of the oropharynx and colon in healthy volunteers was studied. Antimicrobial agents were administered in a randomized cross-over design. No effect on CR of the oropharynx could be demonstrated. Phenethicillin decreased CR of the colon against Enterobacteriaceae (P = 0.001). Co-trimoxazole significantly decreased the concentration of Enterobacteriaceae in faeces (P = 0.03) but the decrease caused by cefaclor and doxycycline did not reach statistical significance. Administration of antimicrobial agents increased the appearance of secondary colonization by Enterobacteriaceae in faeces, especially when Escherichia coli was eliminated. During administration of phenethicillin, secondary colonization occurred at a concentration exceeding 10(7)/g in some volunteers. Following administration of cefaclor, co-trimoxazole and doxycycline, elimination of E. coli may result in the substitution by resistant Gram-negative bacilli in low concentrations.
研究了口服头孢克洛、苯氧乙基青霉素、复方新诺明和强力霉素对健康志愿者口咽部和结肠定植抗力（CR）的影响。抗菌药物采用随机交叉设计给药。未发现对口咽部CR有影响。苯氧乙基青霉素降低了结肠对肠杆菌科细菌的CR（P = 0.001）。复方新诺明显著降低了粪便中肠杆菌科细菌的浓度（P = 0.03），但头孢克洛和强力霉素引起的降低未达到统计学显著性。抗菌药物的使用增加了粪便中肠杆菌科细菌的二次定植出现，尤其是在大肠杆菌被清除时。在服用苯氧乙基青霉素期间，一些志愿者的粪便中二次定植发生时的浓度超过10⁷/g。服用头孢克洛、复方新诺明和强力霉素后，大肠杆菌的清除可能导致低浓度的耐药革兰氏阴性杆菌替代。
