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The effect of FCE 22891, a new oral penem, on faecal flora anaerobes and their fermentation end products in patients with chronic obstructive pulmonary disease

Wirkung des neuen Penems FCE 22891 auf die anaerobe Fäkalflora und ihre Fermentations-Endprodukte bei Patienten mit chronisch obstruktiver Lungenkrankheit

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Summary

The influence of FCE 22891 on the faecal flora was investigated in 11 patients with an acute exacerbation of chronic obstructive pulmonary disease (COPD). Colony counts of faecal (an)aerobes and concentrations of their short-chain fatty acids and organic acids were determined simultaneously in fresh faeces before, during and after administration of the drug, and compared to those of healthy human volunteers. The MIC of FCE 22891 for the 142 isolated anaerobes was determined, and compared to the biologically active concentration of the drug in faeces. TheBacteroides colony counts of the patients increased significantly by day 9 compared to day 3, but were significantly lower than those of the healthy controls before, during and after the study. Significant changes in short-chain fatty acids and organic acid concentrations occurred in faeces of the patients during and after treatment, and especially when compared to healthy controls. A strong increase in MICs during treatment was found inClostridium species, other thanClostridium difficile. FCE 22891 had only a moderate effect on the composition of the anaerobic faecal flora, but bacterial fermentation was mainly disturbed before and early on in treatment, which could have been caused by the disease.

Zusammenfassung

Der Einfluß von FCE 22891 auf die Fäkalflora wurde bei 11 Patienten mit akuter Exazerbation einer chronisch obstruktiven Lungenkrankheit im Vergleich zu gesunden freiwilligen Probanden untersucht. In frischen Stuhlproben, die vor, während und nach Gabe des Antibiotikums gewonnen wurden, wurden die Koloniebildnerzahlen der aeroben und anaeroben Keime und die Konzentrationen kurzkettiger Fettsäuren und organischer Säuren gemessen. Für die 142 Anaerobier-Isolate wurden die MHK-Werte von FCE 22891 bestimmt und mit den biologisch aktiven Konzentrationen der Substanz im Stuhl verglichen. Am Tag 9 waren die Koloniebildnerzahlen vonBacteroides bei den Patienten signifikant höher als am Tag 3, sie lagen jedoch signifikant unter den Werten bei gesunden Probanden vor, während und nach Gabe der Testsubstanz. Während und nach der Therapie kam es zu signifikanten Änderungen der Konzentration kurzkettiger Fettsäuren und organischer Säuren; die Unterschiede waren vor allem im Vergleich zu den gesunden Probanden sehr ausgeprägt. BeiClostridium-Spezies außerClostridium difficile war ein ausgeprägter Anstieg der MHK-Werte von FCE 22891 unter der Therapie festzustellen. FCE 22891 hatte nur mäßig ausgeprägten Einfluß auf die anaerobe Stuhlflora. Die Bakterienfermentation war jedoch vor allem vor und in den ersten Tagen der Behandlung gestört, möglicherweise bedingt durch die Krankheit.

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Authors and Affiliations

  1. Laboratory for Medical Microbiology, State University of Groningen, The Netherlands

    G. J. Meijer-Severs Ph. D. & Edith van Santen B. Sc.

  2. Dept. of Pulmonary Diseases, University Hospital Groningen, Oostersingel 59, NL-9713 EZ, Groningen, The Netherlands

    S. M. T. Puister M. D. & W. G. Boersma M. D., Ph. D.

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  1. G. J. Meijer-Severs Ph. D.
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  2. Edith van Santen B. Sc.
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  3. S. M. T. Puister M. D.
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  4. W. G. Boersma M. D., Ph. D.
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Meijer-Severs, G.J., van Santen, E., Puister, S.M.T. et al. The effect of FCE 22891, a new oral penem, on faecal flora anaerobes and their fermentation end products in patients with chronic obstructive pulmonary disease. Infection 21, 311–317 (1993). https://doi.org/10.1007/BF01712452

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