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  • 1
    ISSN: 1573-904X
    Keywords: Saccharomyces boulardii ; antibiotics ; gastrointestinal kinetics ; interaction ; fecal recovery
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology
    Notes: Abstract Saccharomyces boulardii (SB) is a yeast that is used for the prevention and treatment of antibiotic-associated diarrhea and for the treatment of pseudomembranous colitis. Since SB will most commonly be used when the bacterial flora of the gastrointestinal tract have been disrupted by antibiotic treatment, the influence of different antibiotics on the kinetics and recovery of SB in feces was investigated in rats. Following a single oral dose, SB concentrations in feces were measured for periods of 1 to 6 days. Although SB is eliminated exclusively in the feces, less than 3% of the dose is recovered as viable yeast. When rats were treated with neomycin, which is active against gram-negative aerobic bacteria but not against anaerobes, no change was observed in recovery of SB when compared with recovery from untreated rats. Also, there was no change in the rate at which SB concentrations declined in feces. In contrast, treatment with clindamycin and the broad-spectrum antibiotic ampicillin, which are active against anaerobes, produced an increase in the recovery of SB of up to seven times that of controls and slowed the rate of decline of SB concentration in the feces. This antibiotic effect on SB disposition was also found when SB was administered in multiple doses. An eightfold increase in the steady-state output of SB was observed from ampicillin-treated animals. Analysis of the recovery and kinetic data showed that the primary effect of these antibiotics was to reduce the destruction of SB, probably in the cecum and colon. These studies indicate that viable cells of SB are likely to be present at the highest concentration under those conditions where its action is needed, i.e., in the antibiotic-treated gastrointestinal tract.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1573-904X
    Keywords: Saccharomyces boulardii ; antibiotics ; gastrointestinal kinetics ; dose ; recovery ; biotherapeutic agent
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology
    Notes: Abstract Saccharomyces boulardii (Sb) is a nonpathogenic yeast used to treat intestinal illnesses such as pseudomembranous colitis and antibiotic associated diarrhea. The behavior of this biotherapeutic agent in humans was determined (1) in investigating the effect of dose on the steady-state level and recovery and (2) in quantitating the effect of ampicillin on the recovery and elimination profile. As the Sb dose increased, the mean steady-state concentration of Sb increased significantly. The percentage recovery was dose independent. When a single Sb dose was administered 24 hr after beginning a course of ampicillin, there was a significant increase (P 〈 0.01) in both the area under the concentration versus time curve and the maximum fecal concentration compared to values obtained without ampicillin. Ampicillin increased steady-state recovery of the drug about twofold (P 〈 0.05) and steady-state levels about 2.4 times (P 〈 0.01). These studies have shown that there is a relationship between the dose and the amount of Sb recovered and that perturbation of the GI flora by ampicillin increases steady-state levels of Sb.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1573-2568
    Keywords: pseudomembranous colitis ; diarrhea
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A patient with six documented episodes of recurrentClostridium difficile colitis over an eight-month period is described. Relapses of colitis occurred despite treatment with vancomycin, metronidazole, bacitracin, and cholestyramine. Each recurrence appeared to begin successively closer to the end of the previous course of treatment. Four episodes were sufficiently severe to require hospitalization for rehydration.Saccharomyces boulardii, a nonpathogenic yeast, was begun prior to discontinuing vancomycin therapy for the last recurrence and was continued for three months. Serial stool cultures and assays forC. difficile showed persistence of the organism but rapid reduction of high titers of cytotoxin. No further recurrences of diarrhea or colitis were encountered while the patient was takingSaccharomyces boulardii and for 18 months of follow-up after the yeast was discontinued.
    Type of Medium: Electronic Resource
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