Rao S S, Edwards C A, Austen C J, Bruce C, Read N W
Clinical Research Unit, Royal Hallamshire Hospital, Sheffield, United Kingdom.
Gastroenterology. 1988 Apr;94(4):928-32. doi: 10.1016/0016-5085(88)90549-5.
The aim of this study was to investigate the effect of ampicillin on the ability of the human colon to ferment carbohydrate. The effect of ingesting a drink containing 20 g of lactulose on stool output and breath hydrogen production was measured in 13 normal volunteers before and during administration of ampicillin (2 g/day). Small bowel and whole gut transit times were also measured to exclude any direct effect of ampicillin on motor activity. Ingestion of lactulose did not increase stool weight or frequency under control conditions, but during administration of ampicillin, lactulose caused increases in stool weight (p less than 0.02) and frequency (p less than 0.01), in the percentage of unformed stools (p less than 0.001), and in the excretion of galactose and fructose in stool samples collected from 2 volunteers. Administration of ampicillin also significantly reduced the area under the breath hydrogen profile (p less than 0.03). Mouth-to-cecum transit of the lactulose drink was prolonged during ampicillin ingestion (p less than 0.01) but there was no significant change in the whole gut transit time. These results suggest that ampicillin impairs colonic fermentation of carbohydrate and a diet high in unabsorbable carbohydrate increases the risk of antibiotic-associated diarrhea.
本研究的目的是调查氨苄西林对人体结肠发酵碳水化合物能力的影响。在13名正常志愿者服用氨苄西林（2克/天）之前和期间，测量摄入含有20克乳果糖的饮料对粪便排出量和呼气中氢气产生的影响。还测量了小肠和全肠道转运时间，以排除氨苄西林对运动活性的任何直接影响。在对照条件下，摄入乳果糖不会增加粪便重量或频率，但在服用氨苄西林期间，乳果糖会导致粪便重量增加（p<0.02）、频率增加（p<0.01）、不成形粪便百分比增加（p<0.001），以及从2名志愿者收集的粪便样本中半乳糖和果糖的排泄增加。服用氨苄西林还显著降低了呼气氢气曲线下的面积（p<0.03）。在摄入氨苄西林期间，乳果糖饮料从口腔到盲肠的转运时间延长（p<0.01），但全肠道转运时间没有显著变化。这些结果表明，氨苄西林会损害结肠对碳水化合物的发酵，而高含量不可吸收碳水化合物的饮食会增加抗生素相关性腹泻的风险。
