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Antibiotics
Volume 11
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10.3390/antibiotics11070962
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Article

Co-Administration of Lactulose Crystals with Amoxicillin Followed by Prolonged Lactulose Treatment Promotes Recovery of the Human Gut Microbiome In Vitro

by
Cindy Duysburgh
1,
Pieter Van den Abbeele
1,†,
Dennis Franckenstein
2,
Martin Westphal
2,
Angelika Kuchinka-Koch
3 and
Massimo Marzorati
1,4,*
1
ProDigest BV, Technologiepark 82, 9052 Ghent, Belgium
2
Fresenius-Kabi Deutschland GmbH, Else-Kröner-Str. 1, 64352 Bad Homburg, Germany
3
Fresenius-Kabi Austria GmbH, Estermannstrasse 17, 4020 Linz, Austria
4
Center of Microbial Ecology and Technology (CMET), Ghent University, Coupure Links 653, 9000 Ghent, Belgium
*
Author to whom correspondence should be addressed.
†
Current address: Cryptobiotix SA, Technologiepark 82, 9052 Ghent, Belgium.
Antibiotics 2022, 11(7), 962; https://doi.org/10.3390/antibiotics11070962
Submission received: 20 June 2022 / Revised: 11 July 2022 / Accepted: 13 July 2022 / Published: 18 July 2022
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Abstract

The validated SHIME model was used to assess the effect of repeated administration of two different lactulose dosages (5 g/d and 10 g/d) on the human gut microbiome during and following amoxicillin–clavulanic acid treatment. First, antibiotic treatment strongly decreased Bifidobacteriaceae levels from 54.4% to 0.6% and from 23.8% to 2.3% in the simulated proximal and distal colon, respectively, coinciding with a marked reduction in butyrate concentrations. Treatment with lactulose enhanced acetate and lactate levels during antibiotic treatment, likely through lactulose fermentation by Lachnospiraceae and Lactobacillaceae. One week after cessation of antibiotic treatment, Bifidobacteriaceae levels re-increased to 20.4% and 7.6% in the proximal and distal colon of the 5 g lactulose/d co-administered unit, as compared with 1.0% and 2.2% in the antibiotic-treated unit, and were even further stimulated upon extension of lactulose administration. Marked butyrogenic effects were observed upon prolonged lactulose supplementation, suggesting the establishment of cross-feeding interactions between Bifidobacteriaceae and butyrate producers. Furthermore, a limited Enterobacteriaceae outgrowth following antibiotic treatment was observed upon dosing with 10 g lactulose/d, indicating inhibition of pathogenic colonization by lactulose following antibiotic therapy. Overall, lactulose seems to be an interesting candidate for limiting the detrimental effects of amoxicillin–clavulanic acid on the human gut microbiome, though further studies are warranted to confirm these findings.
Keywords: Bifidobacterium; Lactobacillus; SHIME; antibiotic-associated diarrhoea; dysbiosis; clavulanic acid Bifidobacterium; Lactobacillus; SHIME; antibiotic-associated diarrhoea; dysbiosis; clavulanic acid

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MDPI and ACS Style

Duysburgh, C.; Van den Abbeele, P.; Franckenstein, D.; Westphal, M.; Kuchinka-Koch, A.; Marzorati, M. Co-Administration of Lactulose Crystals with Amoxicillin Followed by Prolonged Lactulose Treatment Promotes Recovery of the Human Gut Microbiome In Vitro. Antibiotics 2022, 11, 962. https://doi.org/10.3390/antibiotics11070962

AMA Style

Duysburgh C, Van den Abbeele P, Franckenstein D, Westphal M, Kuchinka-Koch A, Marzorati M. Co-Administration of Lactulose Crystals with Amoxicillin Followed by Prolonged Lactulose Treatment Promotes Recovery of the Human Gut Microbiome In Vitro. Antibiotics. 2022; 11(7):962. https://doi.org/10.3390/antibiotics11070962

Chicago/Turabian Style

Duysburgh, Cindy, Pieter Van den Abbeele, Dennis Franckenstein, Martin Westphal, Angelika Kuchinka-Koch, and Massimo Marzorati. 2022. "Co-Administration of Lactulose Crystals with Amoxicillin Followed by Prolonged Lactulose Treatment Promotes Recovery of the Human Gut Microbiome In Vitro" Antibiotics 11, no. 7: 962. https://doi.org/10.3390/antibiotics11070962

APA Style

Duysburgh, C., Van den Abbeele, P., Franckenstein, D., Westphal, M., Kuchinka-Koch, A., & Marzorati, M. (2022). Co-Administration of Lactulose Crystals with Amoxicillin Followed by Prolonged Lactulose Treatment Promotes Recovery of the Human Gut Microbiome In Vitro. Antibiotics, 11(7), 962. https://doi.org/10.3390/antibiotics11070962

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