a Mean (standard deviation).

Abbreviations'. +, mild to moderate effect, increase or decrease 2^4-loglO cfu/g feces; + +, strong impact >41ogl0 cfu/g feces; —, no significant changes; d, the detection limit; n.e., not examined.

Cefpodoxime Proxetil

A marked decrease in numbers of aerobic intestinal microorganisms with disappearance of E. coli has been seen during administration of cefpodoxime proxetil in healthy volunteers (18,55). The anaerobic microbiota was also affected and after treatment overgrowth of enterococci, candida and C. difficile occurred.


The ecological impact of cefprozil was determined in a double-blind placebo-controlled study (56). Analysis of the fecal microbiota revealed mainly a moderate decrease in enterobacteria and a few subjects became colonized with C. difficile.


Ceftibuten administration has been shown to partly affect the aerobic intestinal microbiota (57). The numbers of E. coli was significantly reduced while there was an overgrowth of enterococci. Four subjects became colonized with yeasts, mainly C. albicans. The anaerobic microbiota was disturbed to a lesser degree. However, six volunteers were colonized by C. difficile.


The effect of cefuroxime/axetil on the gastrointestinal microbiota has been evaluated in patients (53) and in healthy subjects (21,53,58-60). Ecological disturbances have mainly been observed as decreased numbers of enterobacteria, overgrowth of enterococci and in varied changes in the anaerobic microbiota. In several studies, colonization with Candida species and C. difficile has been observed. Fecal concentrations of cefuroxime/axetil, when measured, have generally been rather low. In one study though, four subjects had very high amounts of the agent in feces and thereby also more pronounced disturbances in the microbiota (60).


Elimination of staphylococci has been shown to be the major significant change in the microbiota occurring during administration of cephradine in healthy volunteers (23).


No major ecological disturbances in the intestinal microbiota have been detected in connection with administration of loracarbef as treatment for acute bronchitis (16) or in healthy volunteers (61). In patients, new aerobic Gram-negative species were detected during the investigation period. However, all strains were susceptible to loracarbef. Loracarbef therapy caused increasing levels of enterococci in infants but had no significant effect on the anaerobic microbiota (7).

Pregnancy And Childbirth

Pregnancy And Childbirth

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