The influence of flucloxacillin and amoxicillin with clavulanic acid on the aerobic flora of the alimentary tract.
In a randomized study, 42 patients undergoing extensive maxillo-facial surgery (correction of the position of the mandible or maxilla by using autologous bone transplants) received prophylactically ten-day courses of either flucloxacillin or amoxicillin with clavulanic acid. Patients were comparable with regard to age and type of surgery. During the prophylactic treatment the effect of antibiotics used on the microbial flora of the alimentary tract was studied. Patients receiving flucloxacillin showed increased numbers of Klebsiella spp. isolated from the faeces (59% of the patients versus 19% of the patients receiving amoxicillin with clavulanic acid). Patients receiving amoxicillin with clavulanic acid showed higher colonization rates of oropharynx with Enterobacteriaceae than patients receiving flucloxacillin (ten patients versus five patients). 60% of those strains isolated from patients receiving amoxicillin with clavulanic acid were resistant to this combination, as compared to 20% of gram-negative bacilli isolated from patients receiving flucloxacillin. In 50% of patients receiving amoxicillin with clavulanic acid, colonization of the gut with yeast occurred, as compared to 18% of patients receiving flucloxacillin. Only one infection leading to a partial loss of the graft was seen in the group of patients receiving flucloxacillin.
Vlaspolder
F
F
Department of Clinical Microbiology, University Hospital Utrecht.
de Zeeuw
G
G
Rozenberg-Arska
M
M
Egyedi
P
P
Verhoef
J
J
D000293:Adolescent; D000328:Adult; D000658:Amoxicillin / Q000494:pharmacology / Q000627:therapeutic use*; D019980:Amoxicillin-Potassium Clavulanate Combination; D001420:Bacteria, Aerobic / Q000187:drug effects* / Q000254:growth & development; D016025:Bone Transplantation; D002648:Child; D002969:Clavulanic Acids / Q000494:pharmacology / Q000627:therapeutic use*; D003023:Cloxacillin / Q000031:analogs & derivatives*; D004064:Digestive System / Q000382:microbiology*; D004338:Drug Combinations / Q000494:pharmacology / Q000627:therapeutic use; D004755:Enterobacteriaceae / Q000187:drug effects / Q000254:growth & development; D005243:Feces / Q000382:microbiology; D005260:Female; D005436:Floxacillin / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009305:Nasopharynx / Q000382:microbiology; D056948:Orthognathic Surgical Procedures; D011292:Premedication; D011897:Random Allocation; D015003:Yeasts / Q000254:growth & development
D002969:Clavulanic Acids; D004338:Drug Combinations; D005436:Floxacillin; D019980:Amoxicillin-Potassium Clavulanate Combination; D000658:Amoxicillin; D003023:Cloxacillin