Gut flora (and probiotics?) and reaction to abx

[Guest guest]

Jim and all,

This is from the Stratton/Wheldon unpublished article

"Metronidazole: a key component of a regimen for the treatment of persistent Chlamydophila pneumoniae infection."

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Discussion

It is generally considered that a single IF titre of 1:512 or higher, in the presence of appropriate symptomatology, is supportive evidence of an infection with C. pneumoniae.3 This serological criterion was met only in three of the five patients, though marked reactions, clinically resembling endotoxaemia, with mild fever, chills, sweating and peripheral vasodilatation certainly occurred in all five patients when metronidazole was added to a doxycycline/macrolide regimen.

It typically began some days after the addition of metronidazole. A reaction of this nature is not a recognised complication of any of these agents in the absence of a sensitive systemic bacterial load. ******Antimicrobial lysis of the gut flora may be expected to cause a rapid but transient increase in an already considerable natural burden of lumenal endotoxins;****** however, selective gut decontamination by oral antibiotics does not alter circulating endotoxin levels.52 Gut mucosa is an efficient barrier to endotoxins, which are not found in the portal circulation in health.53

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Many of us on long term abx take probiotics in an attempt to replenish our gut flora. I have often wondered what the impact of such an intervention might be.

Could the probiotics we take be "using up" our abx as well as causing us to have to deal with constant (much worsened) lysis of much more bacteria than would be otherwise necessary?

Would a compromised gut mucosa (leaky gut) not be the "efficient barrier to endotoxins" that they describe in the article?

Might we be doing ourselves a favour by NOT supplementing with probiotics? Would we be gaining more benefits from making do with "selectively deplenished" gut flora as a result of abx taking?

Nelly

M