Michéa-Hamzehpour M, Auckenthaler R, Kunz J, Pechère J C
Département de Microbiologie, Centre Médical Universitaire, Genève.
Drugs. 1988;35 Suppl 2:6-11. doi: 10.2165/00003495-198800352-00004.
The effect of cefotaxime and ceftriaxone on faecal flora was investigated in women undergoing routine vaginal or abdominal hysterectomy. Three groups of 9 patients received, in a double-blind fashion and just before surgery, cefotaxime 2g intravenously, ceftriaxone 2g intravenously or no antibiotic (controls). Stools were collected before prophylaxis (sample 1) and after surgery (samples 2 and 3). The only alteration after cefotaxime was a decrease of non-fastidious aerobic Gram-negative flora in sample 2. The same effect was more pronounced after ceftriaxone (p less than 0.01) which, in addition, increased yeast colonies (p less than 0.05) in sample 2. In sample 3, more resistant (MIC greater than 32 mg/L) aerobic and anaerobic bacteria were found after ceftriaxone (log10 median 7.5 and 9.0, respectively) than after cefotaxime (4.2 and 6.0) or in controls (4.4 and 6.6) [p less than 0.01 in each case]. Group D streptococci and Gram-positive cocci remained unchanged in the 3 groups. Clostridium difficile cytotoxin assays were negative. The effects on faecal flora were more pronounced after ceftriaxone.
在接受常规阴道或腹部子宫切除术的女性中，研究了头孢噻肟和头孢曲松对粪便菌群的影响。三组患者，每组9例，采用双盲法，在手术前静脉注射2g头孢噻肟、2g头孢曲松或不使用抗生素（对照组）。在预防性用药前（样本1）和手术后（样本2和3）采集粪便。使用头孢噻肟后唯一的变化是样本2中兼性需氧革兰氏阴性菌群减少。使用头孢曲松后同样的效果更明显（p<0.01），此外，样本2中的酵母菌落增加（p<0.05）。在样本3中，使用头孢曲松后发现的耐药性更强（最低抑菌浓度大于32mg/L）的需氧菌和厌氧菌（对数中位数分别为7.5和9.0）比使用头孢噻肟后（4.2和6.0）或对照组（4.4和6.6）更多[每种情况p<0.01]。三组中的D组链球菌和革兰氏阳性球菌保持不变。艰难梭菌细胞毒素检测为阴性。头孢曲松对粪便菌群的影响更明显。
