The effect of antibiotic and probiotic combination therapy on secondary pancreatic infections and oxidative stress parameters in experimental acute necrotizing pancreatitis.
BACKGROUND
Ciprofloxacin and meropenem have effects on intestinal bacteria that are responsible for pancreatic infection, and on the basis of recent data it has been argued that probiotics, especially those used in the food industry, could improve efforts to prevent and treat secondary pancreatic infections by inhibiting bacterial translocation.


OBJECTIVE
To evaluate the effects of probiotic treatment alone or in combination with early administration of two different antibiotics on serum amylase, pancreatic histopathology, bacterial translocation, and oxidative markers.


METHODS
Acute pancreatitis was induced in rats with 3% sodium taurocholate (1 mL/kg intraductally), except in group VI (sham group). After the stabilization period, the rats were divided into seven groups (n = 20) randomly. At hour 6 after injection, group I rats received probiotic Saccharomyces boulardii (25 mg/d orally q.d.), group II received meropenem (60 mg/kg intraperitoneally b.i.d.), group III received ciprofloxacin (40 mg/kg intraperitoneally b.i.d.), group IV received the same dose of probiotic plus meropenem, and group V received probiotic plus ciprofloxacin. Treatment was not given to group VI (sham group) and group VII (pancreatitis group). At hour 48 after induction, specimens were collected.


CONCLUSIONS
Although histopathologic scores in treatment groups were found to be lower than in group VII, the difference was statistically significant only in group V (p < 0.001). In evaluation of oxidative stress, we found that MDA levels decreased and SOD levels increased in treatment groups in comparison with levels in group VII. Probiotic treatment alone reduced bacterial translocation. Probiotic-antibiotic combination therapy was shown to improve histopathologic scores and oxidative parameters.
Akyol
Sedat
S
Department of Internal Medicine, Gülhane School of Medicine, Hacettepe University, Ankara, Turkey.
Mas
M Refik
MR
Comert
Bilgin
B
Ateskan
Umit
U
Yasar
Mehmet
M
Aydogan
Hakan
H
Deveci
Salih
S
Akay
Cemal
C
Mas
Nuket
N
Yener
Nuran
N
Kocar
I Hakki
IH
D000704:Analysis of Variance; D000818:Animals; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000382:microbiology / Q000517:prevention & control*; D018988:Bacterial Translocation / Q000187:drug effects; D002939:Ciprofloxacin / Q000494:pharmacology / Q000627:therapeutic use; D003131:Combined Modality Therapy; D008297:Male; D008315:Malondialdehyde / Q000378:metabolism; D000077731:Meropenem; D018384:Oxidative Stress / Q000187:drug effects*; D019283:Pancreatitis, Acute Necrotizing / Q000188:drug therapy* / Q000378:metabolism / Q000382:microbiology; D019936:Probiotics / Q000494:pharmacology / Q000627:therapeutic use*; D051381:Rats; D017207:Rats, Sprague-Dawley; D012440:Saccharomyces / Q000502:physiology*; D013482:Superoxide Dismutase / Q000378:metabolism; D013656:Taurocholic Acid; D013845:Thienamycins / Q000494:pharmacology / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D013845:Thienamycins; D008315:Malondialdehyde; D013656:Taurocholic Acid; D002939:Ciprofloxacin; D013482:Superoxide Dismutase; D000077731:Meropenem