Decontamination of the bowel in case of antibiotic therapy

Question

Dear expert team,
how can the intestinal flora be maintained in spite of an antibiotic therapy? Is this possible at all? If yes, which substances come into consideration? I have to take Ciprofloxacin capsules in alternation with Tobramycin-inhalations for one year.
Many thanks in advance! Your answers are very helpful!

Answer

Hello,
an antibiotic therapy can have a negative effect on the intestinal flora, because the substances do not differ between the useful intestinal bacteria, which support the digestion and the harmful bacteria, which damage the bowel. For sure there is the one or the other antibiotic substance, that has a more or less radical effect on the intestinal flora. This is among others also dependent on the resistance profile of the bacteria, which colonize the bowel. In the negative case, the therapy with an antibiotic leads to a destruction of the intestinal flora and also probably to the damage of an illness-causing bacterium, however, can at the same time provide the possiblity for another bacterium, which is not affected by the antibiotic drug, to multiply without barrier. Then the result is an inflammation of the bowel mucosa with diarrhea. Bactiera with the name "Clostridium" are in general responsible for such a "Colitis" and in the worst case only are treatable with certain, selected antibiotics.
The direct answer to your question is: one cannot protect the intestinal flora during an antibiotic therapy from the effect of the antibiotic drug, it will be destroyed. Via respective nutrition and other measures one can support a fast recolonization of the bowel with usefull bowel-bacteria. Among this belong the lactic acid bacteria which are in yoghurts and other milk products. Furthermore one can take preparations, which contain the most important bowel bacteria, in order to restore a strong intestinal flora or to keep it up. There are preparations, which contain no less than 12 different bacterial stems, which colonize the small bowel.
Preparations with yeast fungi, which impair the growth of harmful bacteria and should present a support for the protection of the intestinal flora, have to be used with caution. As a rule those are again eliminated after some days, but in case of immuno-suppressed patients or problematic nutrition or impairment of utilization of nutrition one has to be cautious.
Yours sincerely,
C.v.Mallinckrodt

04.10.2010