Skip to main content
SpringerLink
Log in

The effect of ceftriaxone on the anaerobic bacterial flora and the bacterial enzymatic activity in the intestinal tract

Einfluß von Ceftriaxon auf die anaerobe Flora und die bakterielle Enzymaktivität im Intestinaltrakt

  • Originalia
  • Published:
Infection Aims and scope Submit manuscript

Summary

The normal flora of the intestinal tract, mainly consisting of anaerobic bacteria, protects the host against colonization by pathogenic microorganisms. Antimicrobial treatment with ceftriaxone may influence the colonic microflora and as a consequence, the protective effect. Ten healthy volunteers received 1 g of ceftriaxone intramuscularly for five days. This resulted in a significant decrease (p<0.05) of the mean cultural counts (± SEM) of total anaerobes from 10.67 (0.11) (prior to treatment) to 9.02 (0.45) and 8.97 (0.46) at days 3 and 5, respectively (during treatment). After treatment (days 10 and 15–19), the cultural counts of anaerobes returned to 10.17 (0.16) and 10.44 (0.18), respectively. Bacterial enzymes may serve as an indicator of protective microflora. β- aspartylpeptidase and deoxycholate hydrolase activity was determined in faecal supernatants of the volunteers and compared with anaerobic culturing. Both enzymatic activities show a significant correlation with the total number of anaerobes present at day 3 of ceftriaxone treatment. At day 5 and 8 only β-aspartylpeptidase showed significant correlations with cultural counts of total anaerobes,Bacteroides spp. or bifidobacteria. At day 15 to 19 (ten to 14 days after treatment) β-aspartylpeptidase showed only a significant correlation with the number ofBacteroides spp. This indicates that changes in the indigenous bacterial flora during and shortly after treatment with ceftriaxone can be monitored by determination of β-aspartylpeptidase. Recovery of the intestinal flora is difficult to assess in this manner.

Zusammenfassung

Die normale Flora des Intestinaltraktes besteht vorweigend aus anaeroben Bakterien und schützt den Wirt gegen eine Kolonisation durch pathogene Mikroorganismen. Eine antimikrobielle Therapie mit Ceftriaxon kann die Mikroflora des Dickdarms beeinträchtigen und damit auch deren protektiven Effekt. Zehn gesunde Probanden erhielten fünf Tage lang 1 g Ceftriaxon intramuskulär appliziert. Dies führte zu einer signifikanten Abnahme der mittleren Koloniebildnerzahlen von 10,67 (SEM ± 0,11) vor Applikation auf 9,02 (± 0,45) nach drei und auf 8,97 (± 0,46) nach fünf Tagen (p<0,05). Nach zehn und 15 bis 19 Tagen im Anschluß an die Antibiotikagabe kehrten die Anaerobier-Koloniebildnerzahlen auf 10,17 (± 0,16) bzw. 10,44 (± 0,18) zurück. Bakterienenzyme können als Indikator für die protektive Mikroflora dienen. In Überständen von Stuhlproben der Probanden wurden β-Aspartylpeptidase und Desoxycholat-Hydrolase bestimmt und mit den Anaerobier-Kulturen verglichen. Zwischen den Aktivitäten beider Enzyme und der am Tag 3 gemessenen Anaerobier-Gesamtzahl fand sich eine signifikante Korrelation. Am Tag 5 und Tag 8 zeigte nur die β-Aspartylpeptidase eine signifikante Korrelation mit den Gesamt-Kolonie-bildnerzahlen der Anaerobier sowie mit den Zahlen vonBacteroides spp. oder Bifidobakterien. An den Tagen 15 bis 19 (zehn bis 14 Tage nach Antibiotikagabe) bestand nur zwischen der Zahl vonBacteroides spp. und β-Aspartylpeptidase eine signifikante Korrelation. Nach Behandlung mit Ceftriaxon lassen sich folglich Veränderungen der bakteriellen Flora kurzfristig durch Bestimmung der β-Aspartylpeptidase erfassen, weniger gut aber die Erholung der Darmflora.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. van der Waaij, D. Colonization resistance of the digestive tract; clinical consequences and implications. J. Antimicrob. Chemother. 10 (1982) 263–270.

    Google Scholar 

  2. van der Waaij, D., Aberson, J., Thijm, H. A., Welling, G. W. The screening of four aminoglycosides in the selective decontamination of the digestive tract in mice. Infection 10 (1982) 35–40.

    Google Scholar 

  3. van der Waaij, D. The ecology of the human intestine and its consequences for overgrowth by pathogens such asClostridium difficile. Ann. Rev. Microbiol. 43 (1989) 69–87.

    Google Scholar 

  4. Angehrn, P., Probst, P. J., Reiner, R., Then, R. L. Ro 13-9904, a long-acting broad-spectrum cephalosporin:in-vitro andin-vivo studies. Antimicrob. Agents Chemother. 18 (1980) 913–921.

    Google Scholar 

  5. Richards, D. M., Heel, R. C., Brogden, R. N., Speight, T. M., Avery, G. S. Ceftriaxone, a review of its antibacterial activity, pharmacological properties and therapeutic use. Drugs 27 (1984) 469–527.

    Google Scholar 

  6. Arvidsson, A., Alván, G., Angelin, B., Borgå, O., Nord, C. E. Ceftriaxone: renal and biliary excretion and effect on the colon microflora. J. Antimicrob. Chemother. 10 (1982) 207–215.

    Google Scholar 

  7. Bodey, G. P., Fainstein, V., Garcia, I., Rosenbaum, B., Wong, Y. Effect of broad-spectrum cephalosporins on the microbial flora of recipients. J. Infect. Dis. 148 (1983) 892–897.

    Google Scholar 

  8. Nilsson-Ehle, I., Nord, C. E., Ursing, B. Ceftriaxone: Pharmacokinetics and effect on the intestinal microflora in patients with acute bacterial infections. Scand. J. Infect. Dis. 17 (1985) 77–82.

    Google Scholar 

  9. Michéa-Hamzehpour, M., Auckenthaler, R., Kunz, J., Pechère, J.-C. Effect of a single dose of cefotaxime or ceftriaxone on human faecal flora. Drugs 35 (Suppl. 2) (1988) 6–11.

    Google Scholar 

  10. Léonard, F., Andremont, A., Leclerq, B., Labia, R., Tancrède, C. Use of β-lactamase-producing anaerobes to prevent ceftriaxone from degrading intestinal resistance to colonization. J. Infect. Dis. 160 (1989) 274–280.

    Google Scholar 

  11. Welling, G. W. Comparison of methods for the determination of β-aspartylglycine in faecal supernatants of leukemic patients treated with antimicrobial agents. J. Chromatogr. 232 (1982) 55–62.

    Google Scholar 

  12. Holdeman, L. V., Cato, E. P., Moore, W. E. C. (eds. Anaerobe laboratory manual, 4th ed. Virginia Polytechnic Institute and State University, Blacksburg, Va., USA, 1977.

    Google Scholar 

  13. Meijer-Severs, G. J., van Santen, E., Meijer, B. C. Short-chain fatty acids and organic acid concentrations in feces of healthy human volunteers and their correlation with anaerobe cultural counts during systemic ceftriaxone administration. Scand. J. Gastroenterol. 25 (1990) 698–704.

    Google Scholar 

  14. Wissenschaftliche Tabellen Geigy Teilband Statistik. 8th ed. (1980) Geigy, Basel, Switzerland.

    Google Scholar 

  15. Welling, G. W., Groen, G., Welling-Wester, S., de Vries-Hospers, H. G., van der Waaij, D. Enzymatic inactivation of aztreonam by faecal enzyme preparations from healthy volunteers. Infection 15 (1987) 188–191.

    Google Scholar 

  16. Welling, G. W., Stege, G. J. J., Meijer-Severs, G. J. β-aspartylpeptidase activity, a microflora associated characteristic (MAC); its presence in different strains of anaerobic bacteria. Microbial Ecology in Health and Disease 1 (1988) 45–49.

    Google Scholar 

  17. Owen, R. W. The metabolism of bile acids. In:Hill, M. J. (ed.): Microbial metabolism in the digestive tract. CRC Press, Inc., Boca Raton 1986, pp. 52–65.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Laboratorium voor Medische Microbiologie, Rijksuniversiteit Groningen, Oostersingel 59, NL-9713 EZ, Groningen, The Netherlands

    G. W. Welling Ph. D., Geke J. Meijer-Severs M. S., Gé Helmus, Edith van Santen, R. H. J. Tonk, Hilly G. de Vries- Hospers M. D., Ph. D. & D. van der Waaij M. D., Ph. D.

Authors
  1. G. W. Welling Ph. D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Geke J. Meijer-Severs M. S.
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Gé Helmus
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Edith van Santen
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. R. H. J. Tonk
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Hilly G. de Vries- Hospers M. D., Ph. D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. D. van der Waaij M. D., Ph. D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Welling, G.W., Meijer-Severs, G.J., Helmus, G. et al. The effect of ceftriaxone on the anaerobic bacterial flora and the bacterial enzymatic activity in the intestinal tract. Infection 19, 313–316 (1991). https://doi.org/10.1007/BF01645354

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01645354

Keywords

Search

Navigation