Effect of antimicrobial agents on the ecological balance of human microflora.
Effect of antimicrobial agents on the ecological balance of human microflora.
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DOI：
10.1016/s1473-3099(01)00066-4
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发表时间：
2001-09-01
期刊：
影响因子：
--
通讯作者：
Nord, C E
中科院分区：
文献类型：
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作者：
Sullivan, A;Edlund, C;Nord, C E
正常微生物菌群作为屏障，防止潜在致病微生物的定植和已经存在的机会微生物的过度生长。控制机会性微生物的生长被称为定殖抗性。治疗性或预防性的抗菌药物给药会导致宿主和正常微生物菌群之间的生态平衡紊乱。大多数关于抗菌药物对正常微植物群影响的研究是在肠道植物群上进行的。对口咽、皮肤和阴道微生物群落的影响知之甚少。微生物区系的干扰取决于制剂的性质以及吸收、消除途径和可能的酶失活和/或制剂与粪便物质的结合。临床上最常见的肠道菌群失调是腹泻和真菌感染，通常在治疗结束后停止。良好平衡的微生物菌群可防止耐药微生物菌株的建立。通过使用不干扰定殖抗性的抗微生物剂，降低了耐药菌株在患者之间出现和传播以及耐药决定簇在微生物之间传播的风险。在这篇文章中，潜在的生态影响的抗菌药物的管理肠道，口咽，阴道微生物群落进行了总结。该综述基于过去10年发表的临床研究。
The normal microflora acts as a barrier against colonisation of potentially pathogenic microorganisms and against overgrowth of already present opportunistic microorganisms. Control of growth of opportunistic microorganisms is termed colonisation resistance. Administration of antimicrobial agents, therapeutically or as prophylaxis, causes disturbances in the ecological balance between the host and the normal microflora. Most studies on the impact of antimicrobial agents on normal microflora have been carried out on the intestinal flora. Less is known on the effects on oropharyngeal, skin, and vaginal microflora. Disturbances in the microflora depend on the properties of the agents as well as of the absorption, route of elimination, and possible enzymatic inactivation and/or binding to faecal material of the agents. The clinically most common disturbances in the intestinal microflora are diarrhoea and fungal infections that usually cease after the end of treatment. A well-balanced microflora prevents establishment of resistant microbial strains. By using antimicrobial agents that do not disturb colonisation resistance, the risk of emergence and spread of resistant strains between patients and dissemination of resistant determinants between microorganisms is reduced. In this article, the potential ecological effects of administration of antimicrobial agents on the intestinal, oropharyngeal, and vaginal microflora are summarised. The review is based on clinical studies published during the past 10 years.