Bacteria rebound after antibiotics for UC

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Old Mike
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Date Joined Jan 2007
Total Posts : 3879
   Posted 1/7/2008 8:32 AM (GMT -6)   
Thought you might find this interesting.
I also believe this is why antibiotics dont work well for UC, biofilms. Old Mike

Bacterial biofilm suppression with antibiotics for ulcerative and indeterminate colitis: consequences of aggressive treatment.

Humboldt University, Charité Hospital, CCM, Laboratory for Molecular Genetics, Polymicrobial Infections and Biofilms, Berlin, Germany.

BACKGROUND: Antibiotics are commonly used in inflammatory bowel disease (IBD). Little is known about their effect on the mucosal flora. METHODS: The mucosal flora was investigated in colonoscopic biopsies from six groups of 20 IBD patients each. Patients were selected with regard to duration of/interval to combined metronidazole and ciprofloxacin therapy: group I patients with 1 day and group II with 7-14 days of antibiotic therapy, group III-V patients evaluated 1-4 weeks, 2-18 weeks, 26-36 weeks after cessation of antibiotic therapy, respectively. The control group VI included patients without antibiotic therapy. Thirty different fluorescent in situ hybridization (FISH) probes representative of the diversity of the human intestinal flora were applied to all specimens. RESULTS: Bacteria adherent to mucosa could be seen exclusively in DAPI stain and were practically nonamenable to FISH probes in patients on antibiotics (0.001-3 +/- 0.001-5) x 10(10)/mL. Occurrence and concentrations were significantly reduced in groups I and II as compared to untreated controls. The mucosal bacteria were significantly augmented after cessation of antibiotic therapy in group III (13.2 +/- 4.3) and group IV (5.8 +/- 2) but not in group V (1.1 +/- 0.8) as compared to group VI (0.5 +/- 0.4) x 10(10)/mL. Neither Bacteroides nor Enterobacteriaceae groups were permanently suppressed by metronidazole-ciprofloxacin therapy. CONCLUSIONS: The suppressing effects of antibiotics on the mucosal flora are accompanied by massive rebound effects. The concentrations of mucosal bacteria are dramatically increased as soon as 1 week after cessation of antibiotic therapy, remaining at a level that is at least one power higher over a period of 5 months as compared to the group without antibiotic treatment.

PMID: 18164963 [PubMed - in process]

Regular Member

Date Joined Nov 2007
Total Posts : 393
   Posted 1/7/2008 4:57 PM (GMT -6)   
am i understanding that the antibiotics were not good for the mucosa lining? i did not know that they were used as a treatment for uc if there were no bacteria
present. i do believe antibiotics are what did my daughter in, she took so many over the years for sinus infections, if they only looked ateher sinuses earlier she may have been spared
it took me waking up too late in the game to ask for the cat scan. one year sooner may have changed everything. i don't know how i will feel if she ever has to take them, they are now poison to me.
that being said she is planning to go to mexico in april-against my better judgement- but if she is well enough at the time it will be hard to reason her out of it and the dr said she should take xifaxan as
a profalctic? anyway -just thinking out loud.-thanks
Mom to 19 year old daughter diagnosed 11/07.
asacol 2 3x daily
colazal 3 3x daily
proctofoam 3x daily
mesalamine enema 1x daily
canasa suppostiories 3x daily (usually doesn't get to do 3)
culturelle probiotic 1 daily
chewable vitamin
hydrocortisone enema at bed tme/now every other night

Elite Member

Date Joined Feb 2004
Total Posts : 20577
   Posted 1/7/2008 5:09 PM (GMT -6)   
Reason why it's sooooooo important to take a good probiotic daily, remission or not.

My bum is broken....there's a big crack down the middle of it!  LOL  :)

Elite Member

Date Joined Mar 2003
Total Posts : 10407
   Posted 1/7/2008 5:10 PM (GMT -6)   
I'm interpreting this as the normal bacterial flora in the gut respond after an antibiotic attack by reproducing more quickly and you end up having a higher level of "good" bacteria than those who haven't taken antibiotics. Is that how you read it?
Moderate to severe left-sided UC (21 cm) diagnosed 2001.
Intolerant to Asacol and rectal mesalamine preparations.
On Prednisone then Entocort 2001-2006 with only short periods off. 
Current meds are Colazal, Azathioprine Remicade, Nature's Way Primadophilus Reuteri.
In remission since April, 2006. Remicade has been my wonder drug.

Regular Member

Date Joined Sep 2007
Total Posts : 196
   Posted 1/8/2008 3:01 PM (GMT -6)   

Judilyn, that is what it looks to me: the "at least one power higher" is concerning, though I can say not surprising.  The bad bacteria typically grow back faster than the good, and our diets usually don't aid the good so much as the bad.

For what it is worth, I had to take a course of antibiotics for a tooth infection starting a couple weeks ago and opted for least destructive type: penicillin over against another type (I saw two dentists, giving two different Rx) that can cause a type of colitis in even "normal people".  I noticed blood returned to my stool, which was not an issue for a few months up unto that point.  However, I kept up with the probiotics (giving it usually a couple hours after the antibiotics), even thinking it might be of some benefit to kill off the bad, but replenishing with the good.  I finished with the antibiotics this past Saturday and the blood almost immediately stopped and I have been feeling much better since probably last Thursday, where for the first time in a long time, I feel like I can return to work and function quasi-normally in life without quite so much panic/fear/anxiety.

If anyone needs to take antibiotics, it can definitely be dangerous for people with UC, but you can also look at it as an opportunity to supply your body with good bacteria and also good yeast (e.g. Saccharomyces Boulardii, which is not affected by antibiotics and shown very effective against antibiotic associated Diarrhea).  Something I probably should have tried, since everything is getting killed off so fast is a probiotic enema while on the antibiotics.

So thems is my thoughts.

Pancolitis '04
Yet to ever go into remission, additional Flare-up since Aug 12th
Time off work since 10/17. 
Finally seeing some improvement; likely was complicated with a digestional yeast overgrowth.
On Lialda (2/dy), Probiotics, Fish Oil, Folic Acid, Alpha Lipoic Acid, Borage Oil

Veteran Member

Date Joined Mar 2007
Total Posts : 4509
   Posted 1/8/2008 7:23 PM (GMT -6)   
Judilyn said...
I'm interpreting this as the normal bacterial flora in the gut respond after an antibiotic attack by reproducing more quickly and you end up having a higher level of "good" bacteria than those who haven't taken antibiotics. Is that how you read it?
That's how I read it, too. Wouldn't this be a good thing to have more "good" bacteria?
23 years old
Diagnosed with UC March 2007; yet to go into remission
Current inflamation in the rectum
Asacol 4 tablets 3x/day
Rowasa (generic) - daily
Nature's Way Primadophilus Reuteri 1/day; Chewable multivitamin; Metamucil; Viactiv (Calcium and Vit. D)

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