Prospective evaluation of the impact of amoxicillin, clarithromycin and their combination on human gastrointestinal colonization by Candida species.
BACKGROUND
Amoxicillin and clarithromycin have been used extensively for the eradication of Helicobacter pylori. However, no study has examined the impact of their combination on the Candida albicans concentration of the gastrointestinal (GI) tract. This is the first study examining and comparing directly the effect of amoxicillin, clarithromycin and their combination on the C. albicans concentration of the human GI tract.


METHODS
Thirty-three adult patients (11 in each antibiotic group) were studied prospectively. Quantitative stool cultures for Candida were conducted at the beginning, the end and 1 week after the discontinuation of antibiotic treatment.


RESULTS
All three regimens increased the GI colonization in patients by Candida. The combination of amoxicillin with clarithromycin caused the highest increase; however, this was not statistically significant.


CONCLUSIONS
Amoxicillin and clarithromycin used either alone or in combination cause a small to moderate increase in GI colonization by Candida. Hence, these drugs could be safely used in patients at risk for candidiasis originating from the GI tract.
Maraki
S
S
Division of Medicine, University of Crete, Heraklion, Crete, Greece.
Mouzas
I A
IA
Kontoyiannis
D P
DP
Chatzinikolaou
I
I
Tselentis
Y
Y
Samonis
G
G
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000658:Amoxicillin / Q000008:administration & dosage / Q000494:pharmacology*; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000494:pharmacology*; D002176:Candida albicans / Q000254:growth & development / Q000302:isolation & purification*; D002177:Candidiasis; D017291:Clarithromycin / Q000008:administration & dosage / Q000494:pharmacology*; D004064:Digestive System / Q000187:drug effects / Q000382:microbiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010406:Penicillins / Q000008:administration & dosage / Q000494:pharmacology*; D011157:Population Dynamics; D011446:Prospective Studies; D012307:Risk Factors
D000900:Anti-Bacterial Agents; D010406:Penicillins; D000658:Amoxicillin; D017291:Clarithromycin