Capurso Lucio, Koch Maurizio
Primario Emerito Gastroenterologia, Ospedale San Filippo Neri, Roma.
Senior Director, Unità Complessa di Gastroenterologia ed Epatologia, Ospedale San Filippo Neri, Roma.
Recenti Prog Med. 2021 Jan;112(1):4-26. doi: 10.1701/3551.35254.
Antibiotics are some of the most frequently prescribed medications worldwide, but antibiotic therapy may disturb the colonization resistance of gut microbiota to pathogenic bacteria, resulting in a range of symptoms that include, most notably, diarrhea that occurs between 7% and 33% of adults and 66 and 80% in pediatric patients (median of 22%) who take antibiotics. The diverse class of antibiotics may damage the metabolic homeostasis and can alter the level of intestinal metabolites including amino acids, bile acids, glucose, short chain fatty acids through alteration in abundance of metabolically active bacteria. Clostridium difficile is the main cause of antibiotics associated diarrhea: 3rd generation Cephalosporin, Clyndamicin, 2nd and 4th generation Cephalosporines, Sulfamethoxazole-trimethoprim, Quinolones, Penicillin combination show the strongest association with diarrhea.
抗生素是全球范围内最常被处方的药物之一,但抗生素治疗可能会扰乱肠道微生物群对病原菌的定植抗性,导致一系列症状,其中最显著的是腹泻,在服用抗生素的成年人中发生率为7%至33%,在儿科患者中为66%至80%(中位数为22%)。种类繁多的抗生素可能会破坏代谢稳态,并通过改变代谢活跃细菌的丰度来改变包括氨基酸、胆汁酸、葡萄糖、短链脂肪酸在内的肠道代谢物水平。艰难梭菌是抗生素相关性腹泻的主要原因:第三代头孢菌素、克林霉素、第二代和第四代头孢菌素、磺胺甲恶唑-甲氧苄啶、喹诺酮类、青霉素组合与腹泻的关联最为密切。