Genetics Department, AVVA Pharmaceuticals Ltd, 23A Spyrou Kyprianou, 4001, Limassol, Cyprus.
Research and Development, MC Development LLC, Moscow, Russia.
World J Pediatr. 2020 Apr;16(2):168-176. doi: 10.1007/s12519-019-00315-6. Epub 2019 Oct 3.
Next-generation sequencing has revolutionized our perspective on the gut microbiome composition, revealing the true extent of the adverse effects of antibiotics. The impact of antibiotic treatment on gut microbiota must be considered and researched to provide grounds for establishing new treatment strategies that are less devastating on commensal bacteria. This study investigates the impact on gut microbiome when a commonly used antibiotic, azithromycin is administered, as well as uncovers the benefits induced when it is used in combination with lactulose, a prebiotic known to enhance the proliferation of commensal microbes.
16S rRNA gene sequencing analysis of stool samples obtained from 87 children treated with azithromycin in combination with or without lactulose have been determined. Children's gut microbial profile was established at the pre- and post-treatment stage.
Azithromycin caused an increase in the relative abundance of opportunistic pathogens such as Streptococcus that was evident 60 days after treatment. While few days after treatment, children who also received lactulose started to show a higher relative abundance of saccharolytic bacteria such as Lactobacillus, Enterococcus, Anaerostipes, Blautia and Roseburia, providing a protective role against opportunistic pathogens. In addition, azithromycin-prebiotic combination was able to provide a phylogenetic profile more similar to the pre-treatment stage.
It is suggested that during azithromycin treatment, lactulose is able to reinstate the microbiome equilibrium much faster as it promotes saccharolytic microbes and provides a homeostatic effect that minimizes the opportunistic pathogen colonization.
下一代测序技术彻底改变了我们对肠道微生物组组成的看法，揭示了抗生素的不良影响的真实程度。必须考虑和研究抗生素治疗对肠道微生物群的影响，为建立对共生菌破坏性较小的新治疗策略提供依据。本研究调查了常用抗生素阿奇霉素给药时对肠道微生物组的影响，并揭示了当它与乳果糖联合使用时所带来的益处，乳果糖是一种已知能促进共生微生物增殖的益生元。
对 87 名接受阿奇霉素联合或不联合乳果糖治疗的儿童的粪便样本进行了 16S rRNA 基因测序分析。在治疗前和治疗后阶段建立了儿童的肠道微生物群特征。
阿奇霉素导致机会性病原体（如链球菌）的相对丰度增加，这在治疗后 60 天就很明显。而在治疗几天后，同时接受乳果糖的儿童开始表现出更高的产酸菌（如乳杆菌、肠球菌、厌氧螺菌、布劳特氏菌和罗氏菌）的相对丰度，对机会性病原体起到了保护作用。此外，阿奇霉素-益生元联合治疗能够提供更类似于治疗前阶段的系统发育特征。
建议在阿奇霉素治疗期间，乳果糖能够更快地恢复微生物组平衡，因为它促进了产酸菌的生长，并提供了一种最小化机会性病原体定植的动态平衡效应。
