Effect of cheese consumption on emergence of antimicrobial resistance in the intestinal microflora induced by a short course of amoxicillin-clavulanic acid.
OBJECTIVE
To study in a sequential prospective trial, the effect of cheese consumption on the emergence of Escherichia coli and enterococci resistance to amoxicillin after amoxicillin-clavulanic acid (amoxiclav) treatment.


RESULTS
The study comprised two phases separated by 1 year. Each phase lasted 75 days for each volunteer (from day -13 to day 61). During the first phase, 18 healthy volunteers were given a 1-g dose of amoxiclav orally twice a day for 5 days (from day 0 to day 4). The design of phase 2 was identical to that of phase 1, except that the volunteers consumed 100 g of hard-cooked cheese from day -6 to day 19. Faecal samples were collected 20 times throughout the trial and were quantitatively assayed for total and amoxicillin-resistant (Amox(R)) E. coli and enterococci. The consumption of experimental cheese was associated with a decrease of Amox(R) enterococci during the post-antibiotic period, with the maximum level of Amox(R) enterococci falling from 6.2% to 0.03%. This effect was not observed for E. coli, and the type of cheese (raw milk vs pasteurized milk) did not influence the results.


CONCLUSIONS
Consumption of cheese during amoxiclav treatment reduces the emergence of Amox(R) enterococci in faeces. SIGNIFICANCE AND CLINICAL IMPACT OF THE STUDY: Our clinical pilot trial suggests that there are likely to be benefits from consuming probiotic-containing cheese during antibiotic treatment.
Bertrand
X
X
Service d'Hygiène Hospitalière, Centre Hospitalier Universitaire de Besançon, Besançon, France. xavier.bertrand@univ-fcomte.fr
Dufour
V
V
Millon
L
L
Beuvier
E
E
Gbaguidi-Haore
H
H
Piarroux
R
R
Vuitton
D A
DA
Talon
D
D
D019980:Amoxicillin-Potassium Clavulanate Combination / Q000494:pharmacology*; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D002611:Cheese / Q000382:microbiology*; D016983:Enterococcus / Q000378:metabolism*; D004926:Escherichia coli / Q000187:drug effects*; D005243:Feces / Q000382:microbiology; D005602:France; D006801:Humans; D007422:Intestines / Q000187:drug effects* / Q000382:microbiology; D008137:Longitudinal Studies; D019936:Probiotics / Q000378:metabolism
D000900:Anti-Bacterial Agents; D019980:Amoxicillin-Potassium Clavulanate Combination