IMPACT OF CEFUROXIME-AXETIL ON THE NORMAL INTESTINAL MICROFLORA

Ten healthy volunteers were given 250 mg cefuroxime-axetil tablets b.i .d. for 10 d. Stool samples were collected before, during and after ce furoxime-axetil administration. The mean concentrations of cefuroxime in faeces on days 7 and 10 were 0.57 mg/kg (range <0.125-0.84 mg/kg) a nd 0.48 mg/kg (range <0.125-1.35 mg/kg) respectively. There was an ove rgrowth of enterococci and staphylococci, while the levels of bacilli and enterobacteria were not significantly altered during the administr ation period. Six subjects became colonised by Candida albicans and th ree by Clostridium difficile during and after the administration perio d. Two of the volunteers with C. difficle reported mild diarrhoea duri ng the administration period. The number of bifidobacteria and clostri dia decreased while the levels of eubacteria and bacteroides were unaf fected by cefuroxime-axetil administration. Beta-Lactamase activities in faeces were found in six volunteers and increased significantly dur ing the administration period (P<0.05). There was a clear relationship between beta-lactamase activities in faeces, concentrations of cefuro xime and alterations in the normal microflora. Low cefuroxime concentr ations in faeces corresponded to high beta-lactamase activities and mi nor alterations in the normal microflora, while high cefuroxime concen trations in faeces corresponded to low beta-lactamase activities and c onsiderable ecological disturbances in the faecal microflora.