[Ecologic impact of antibiotherapy. Role of substitution microorganisms in the control of antibiotic-related diarrhea and colitis].
Mild or severe episodes of diarrhoea are the main side effects of antibiotic therapy. The major form of intestinal disorders is pseudomembranous colitis due to Cl. difficile. Among ecological means for control of these diarrhoea, which result from disruption of the intestinal ecosystem, several non-pathogenic microorganisms can be used in order to establish a new equilibrium; among the available microorganisms, S. boulardii is a non-pathogenic yeast, which has given rise to many experimental and clinical studies. Moreover, results of an in vitro study of susceptibilities to antibiotics of the available microorganisms are reported; for S. boulardii, these in vitro data confirm the bases of persistence of the organism in the gut during antibiotic therapy. Besides these in vitro data, experimental studies in animal models (gnotobiotic mice and hamsters with Cl. difficile colitis) have confirmed the potential effectiveness of S. boulardii in preventing the pathogenic effect of toxins A and B and in decreasing numbers of Cl. difficile colonies in the gut. Similarly, in intensive care unit patients, controlled prospective studies have shown that administration of S. boulardii prevented diarrhoea, pseudo-membranous colitis and intestinal translocation of gram-negative bacilli when combined with selective digestive decontamination.
Bergogne-Bérézin
E
E
Service de Microbiologie, CHU Bichat-Claude Bernard, Paris.
D000818:Animals; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D001419:Bacteria; D003967:Diarrhea / Q000139:chemically induced / Q000382:microbiology / Q000517:prevention & control*; D004463:Ecology; D004761:Enterocolitis, Pseudomembranous / Q000382:microbiology / Q000517:prevention & control*; D006801:Humans
D000900:Anti-Bacterial Agents
Impact écologique de l'antibiothérapie. Place des microorganismes de substitution dans le contrôle des diarrhées et colites associées aux antibiotiques.