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Journal of Antimicrobial Chemotherapy (1988) 22, 747-758
© 1988 The British Society for Antimicrobial Chemotherapy

research-article

Influence of cefaclor, phenethicillin, co-trimoxazole and doxycycine on colonization resistance in healthy volunteers

E. J. Vollaarda, H. A. L. Clasenerb, A. J. A. van Griethuysenb, A. J. H. M. Janssenb, A. H. J. Sanders-Reijmersb, N. F. Mullera and P. J. C. Huigec

aDepartment of Pharmacy, Canisius-Wilhelmina Hospital St. Annastraat 289, 6525 GT Nijmegen, The Netherlands bDepartment of Microbiology, Canisius-Wilhelmina Hospital St. Annastraat 289, 6525 GT Nijmegen, The Netherlands cDepartment of Eli Lilly, Canisius-Wilhelmina Hospital St. Annastraat 289, 6525 GT Nijmegen, The Netherlands

Received 25 January 1988; returned 16 June 1988; accepted 16 June 1988

The influence of oral administration of cefaclor, phenethicillin, co-trimoxazole and doxycycline on colonization resistance (CR) of the oropharynx and colon in healthy volunteers was studied. Antimicrobial agents were administered in a randomized cross-over design. No effect on CR of the oropharynx could be demonstrated. Phenethicillin decreased CR of the colon against Enterobacteriaceae in faeces(P = 0.001). Co-trimoxazole significantly decreased the concentration of Enterobacteriaceae in faeces (P = 0.03) but the decrease caused by cefaclor and doxycycline did not reach statistical significance. Administration of antimicrobial agents increased the appearance of secondary colonization by Enterobacteriaceae in faeces, especially when Escherichia coli was eliminated. During administration of phenethicillin, secondary colonization occurred at a concentration exceeding 107/g in some volunteers. Following administration of cefaclor, co-trimoxazole and doxycycline, elimination of E. coli may result in the substitution by resistant Gram-negative bacilli in low concentrations.


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