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Enterobacteriaceae suppression by three different oral doses of polymyxin E in human volunteers

Published online by Cambridge University Press:  19 October 2009

J. J. M. van Saene ,
H. K. F. van Saene ,
N. J. Ph. Tarko-Smit  and
G. J. J. Beukeveld
J. J. M. van Saene
Affiliation:
Laboratory for Pharmaceutical Technology and Dispensing, University of Groningen, A. Deusinglaan 2, 9713 AW Groningen, The Netherlands
H. K. F. van Saene
Affiliation:
Department of Medical Microbiology, University of Liverpool, P.O. Box 147, Liverpool L69 3BX, UK
N. J. Ph. Tarko-Smit
Affiliation:
Laboratory for Pharmaceutical Technology and Dispensing, University of Groningen, A. Deusinglaan 2, 9713 AW Groningen, The Netherlands
G. J. J. Beukeveld
Affiliation:
Central Laboratory for Clinical Chemistry, University Hospital, Oostersingel 59, 9713 EZ Groningen, The Netherlands
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Polymyxin E is frequently used as an oral drug for flora suppression of the gastrointestinal canal. The suppression effect is dose dependent because polymyxin E is moderately inactivated by faecal and food compounds. Three oral polymyxin E doses (150, 300, 600 mg daily) were given to six volunteers for 6 days. The Enterobacteriaceae suppression effect was compared by means of the suppression index i.e. ratio of total number of faecal samples free of Enterobacteriaceae to the total number of faecal samples. The impact on the indigenous (mostly anaerobic) flora was measured in four ways: (i) beta-aspartylglycine content; (ii) volatile fatty acid pattern; (iii) yeast overgrowth and (iv) Streptococcus faecalis decrease. Enterobacteriaceae suppression was most successful during 600 mg oral polymyxin E (suppression indices during 150, 300 and 600 mg were 0·32, 0·55 and 0·89 respectively). None of the four markers of indigenous flora alterations were positive. However, using this dosage half of the volunteers suffered rather severe gastrointestinal side-effects. Oral polymyxin E in a dosage of minimum 600 mg daily seems to possess the ideal properties of a flora suppression agent, if the gastrointestinal side-effects could be mitigated.

Type
Research Article
Information
Epidemiology & Infection , Volume 100 , Issue 3 , June 1988 , pp. 407 - 417
Copyright
Copyright © Cambridge University Press 1988

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