Influence of amoxycillin, erythromycin and roxithromycin on colonization resistance and on appearance of secondary colonization in healthy volunteers

We investigated the influence of oral administration of amoxycillin, erythromycin and roxithromycin on colonization resistance in healthy volunteers. Antibiotics were administered in a randomized cross-over design. No effect on the colonization resistance of the oropharynx could be demonstrated. Amoxycillin decreased the colonization resistance of the bowel against Enterobacteriaceae and yeasts, whose median concentration in faeces increased 100-fold and 30-fold respectively. Roxithromycin and erythromycin decreased the concentration of Enterobacteriaceae in faeces. Secondary colonization with Enterobacteriaceae was detected as often following roxithromycin as following amoxycillin, but the level of colonization with these bacteria was much higher following amoxycillin. Following roxithromycin and erythromycin the level of secondary colonization did not exceed the original concentration of Enterobacteriaceae, showing that these antibiotics did not decrease the colonization resistance against Enterobacteriaceae. The appearance of secondary colonization in faeces at levels equal to or lower than the concentration of Enterobacteriaceae before administration of antibiotics, should not be regarded as proof of disturbance of colonization resistance.