Oral antibiotic treatment of Helicobacter pylori leads to persistently reduced intestinal colonization rates with Oxalobacter formigenes.
OBJECTIVE
Oxalobacter formigenes (OF) may play a protective role in preventing calcium oxalate stones. This is the first prospective study to evaluate the effect of antibiotics on OF colonization. Intestinal colonization by OF is associated with reduced urinary oxalate excretion. Exposure to antibiotics may be an important factor determining rates of colonization.


METHODS
The effect of antibiotics on OF colonization was compared in two groups: A group receiving antibiotics for gastric infection with Helicobacter pylori (HP) and a group without HP whose members were not receiving antibiotics. OF colonization in stool was detected by oxalate degradation at baseline and after 1 and 6 months.


RESULTS
The prevalence at baseline of intestinal colonization with OF was 43.1% among all patients screened. Among the 12 patients who were positive for OF who did not receive antibiotics, 11 (92%) had OF on stool tests at 1 month and 6 months. Of the 19 participants who were positive for OF and who received antibiotics for HP, only 7 (36.8%) continued to be colonized by OF on follow-up stool testing at 1 and 6 months (P=0.003 by Fisher exact test). Amoxicillin and clarithromycin caused 62.5% of subjects to become negative for OF at 1 month; 56.2% remained negative for OF at 6 months.


CONCLUSIONS
Antibiotics for HP infection effectively reduced colonization with OF, an effect present at 1 and 6 months after treatment. The lasting elimination of OF could be associated with hyperoxaluria and be a factor in recurrent kidney stone disease.
Pharmacy Benefits Management, Veterans Integrated Service Network 3, New York Harbor Veterans Affairs Medical Center, New York, New York, USA.
Viktoria
V
Kharlamb
Jennifer
J
Schelker
Fritz
F
Francois
Juquan
J
Jiang
Ross P
RP
Holmes
David S
DS
Goldfarb
D000284:Administration, Oral; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000494:pharmacology*; D015169:Colony Count, Microbial; D005243:Feces / Q000382:microbiology; D005500:Follow-Up Studies; D016480:Helicobacter pylori / Q000187:drug effects* / Q000254:growth & development*; D006801:Humans; D007422:Intestines / Q000187:drug effects / Q000382:microbiology*; D020624:Oxalobacter formigenes / Q000187:drug effects* / Q000254:growth & development*
D000900:Anti-Bacterial Agents