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Short bowel syndrome (SBS) is a malabsorptive condition that most often results from major intestinal resection and may lead to intestinal failure (IF) in case of dependency on intravenous nutrition. Enteral drug absorption is considered to be unpredictable in SBS patients. Evidence is mounting, however, that many SBS patients have at least some residual intestinal uptake of nutrients and/or drugs. It remained unclear to what extent adequate plasma concentrations of antimicrobial agents could be achieved in these patients. This issue is highly relevant in SBS/IF patients in light of their increased risk for catheter-related infections, and to avoid needless, costly and more risky intravenous treatment.
Researchers Julia Korzilius, Michelle Gompelman, Roger Brüggemann, Geert Wanten, and others determined the bioavailability of orally administered antimicrobial agents (ciprofloxacin, clindamycin, flucloxacillin, and fluconazole) commonly used for treatment in SBS patients. The research group from the Department of Gastroenterology and Hepatology published the results in the Journal of Antimicrobial Chemotherapy on 12 June 2023.
The authors found that the bioavailability of selected oral antimicrobial agents in certain SBS patients appeared to be substantially better than expected, promising oral treatment as a feasible treatment option in certain clinical scenarios. Hence, future studies will explore the feasibility of oral antimicrobial agents in SBS patients with mild infections.
Publication Journal of Antimicrobial Chemotherapy | Oxford Academic (oup.com)
Oral antimicrobial agents in patients with short bowel syndrome: worth a try!
Korzilius JW, Gompelman M, Wezendonk GTJ, Jager NGL, Rovers CP, Brüggemann RJM, Wanten GJA. Oral antimicrobial agents in patients with short bowel syndrome: worth a try! J Antimicrob Chemother. 2023 Jun 30:dkad198. doi: 10.1093/jac/dkad198. Epub ahead of print. PMID: 37390353.
