A new macrocyclic antibiotic, fidaxomicin (OPT-80), causes less alteration to the bowel microbiota of Clostridium difficile-infected patients than does vancomycin
A new macrocyclic antibiotic, fidaxomicin (OPT-80), causes less alteration to the bowel microbiota of Clostridium difficile-infected patients than does vancomycin
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DOI：
10.1099/mic.0.042010-0
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发表时间：
2010-11-01
期刊：
影响因子：
2.8
通讯作者：
Louie, Thomas
中科院分区：
文献类型：
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作者：
Tannock, Gerald W.;Munro, Karen;Louie, Thomas
艰难梭菌感染（CDI）是住院患者腹泻最常见的可识别原因。目前的治疗方法依赖于甲硝唑或万古霉素的施用，这会减少肠道中艰难梭菌的繁殖种群。当这些抗生素治疗停止时疾病复发表明甲硝唑和万古霉素不仅影响艰难梭菌，而且影响通常介导竞争排斥的共生群体。 Fidaxomicin 是一种抑制艰难梭菌的新型抗生素。我们的研究表明，非达霉素对粪便微生物群的主要系统发育簇的组成几乎没有影响。值得注意的是，与万古霉素治疗相比，非达霉素对梭菌簇XlVa和IV以及双歧杆菌的影响要小得多。这些发现有助于解释最近的临床试验中用非达霉素治疗 CDI 后复发率大幅降低的原因。
Clostridium difficile infection (CDI) is the most common identifiable cause of diarrhoea in hospitalized patients. Current therapies rely on the administration of metronidazole or vancomycin, which reduce vegetative populations of C. difficile in the bowel. Recurrence of the disease when treatment with these antibiotics ceases indicates that metronidazole and vancomycin affect not only C. difficile but also commensal populations that normally mediate competitive exclusion. Fidaxomicin is a new antibiotic that inhibits C. difficile. Our study shows that fidaxomicin had little effect on the composition of the faecal microbiota in terms of its major phylogenetic clusters. Notably, clostridial clusters XlVa and IV, and Bifidobacterium, were much less affected by fidaxomicin compared to vancomycin treatment. These findings help to explain the substantially reduced rates of relapse following treatment of CDI with fidaxomicin in recent clinical trials.