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22.06.2021 | Original Article

Fecal microbiome alterations in pediatric patients with short bowel syndrome receiving a rotating cycle of gastrointestinal prophylactic antibiotics

verfasst von: Le Yi Phyo, Kamonnut Singkhamanan, Wison Laochareonsuk, Komwit Surachat, Napasorn Phutong, Kaimook Boonsanit, Piyawan Chiengkriwate, Surasak Sangkhathat

Erschienen in: Pediatric Surgery International | Ausgabe 10/2021

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Abstract

Background

Pediatric patients with short bowel syndrome (SBS) are at risk of developing small intestinal bacterial overgrowth (SIBO). Prevention of SIBO using cyclic enteric antibiotics has been implemented to control the balance in microbial ecosystems, although its effectiveness has not been well studied.

Purpose

This study aimed to explore the change in the gut microbial composition in SBS patients during cyclic antibiotic phases and antibiotic-free period, and to compare the microbiota composition between healthy controls and SBS patients.

Method

SBS patients taking oral metronidazole alternating with trimethoprim–sulfamethoxazole (TMP–SMT) and antibiotic-free conditions as a ‘10-day cyclic protocol’ were involved in fecal microbiome study using Illumina 16S sequencing.

Results

When healthy control possessed the majority of Bacteroidetes spp. (54%) and Firmicutes spp. (33%), the microbial composition in SBS patients especially Firmicutes spp. and Proteobacteria spp. was prominently changed in each phase of treatment. In antibiotic-free period, SBS patients displayed 49% Firmicutes and 36% Proteobacteria. However, higher Proteobacteria than Firmicutes were detected at the commencement of metronidazole (58% versus 33%). Similarly, 56% Proteobacteria and 27% Firmicutes were found during TMP–SMT. Escherichia coli increased prominently during the antibiotic periods.

Conclusion

Prophylactic antibiotics change the gut microbiota composition in an unfavorable direction, especially when repeatedly used for a long period. This practice should be reconsidered.

Level of evidence

III.

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Titel: Fecal microbiome alterations in pediatric patients with short bowel syndrome receiving a rotating cycle of gastrointestinal prophylactic antibiotics
verfasst von: Le Yi Phyo
Kamonnut Singkhamanan
Wison Laochareonsuk
Komwit Surachat
Napasorn Phutong
Kaimook Boonsanit
Piyawan Chiengkriwate
Surasak Sangkhathat
Publikationsdatum: 22.06.2021
Verlag: Springer Berlin Heidelberg
Erschienen in: Pediatric Surgery International / Ausgabe 10/2021
Print ISSN: 0179-0358
Elektronische ISSN: 1437-9813
DOI: https://doi.org/10.1007/s00383-021-04948-5

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Fecal microbiome alterations in pediatric patients with short bowel syndrome receiving a rotating cycle of gastrointestinal prophylactic antibiotics

Abstract

Background

Purpose

Method

Results

Conclusion

Level of evidence

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Abstract

Background

Purpose

Method

Results

Conclusion

Level of evidence

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