Augmentin: a 'novel' treatment for SIBO and gut dismotility?

May 2, 2012

I recall Bradstreet saying that Augmentin is the about the only abx that still works for 'strep' (probably an umbrella term now) in autism… A treatment option for SIBO which has benefits beyond its antibacterial effect. More motility should equal less bacterial growth in the small intestine. If more motility can lead to a decrease in intestinal permeability, still needs to be determined. Resistance remains a problem, however.http://www.sciencedaily.com/releases...0430114945.htmScienceDaily (Apr. 30, 2012) — The common antibiotic, amoxicillin-clavulanate, may improve small bowel function in children experiencing motility disturbances, according to a study appearing in the June print edition of the Journal of Pediatric Gastroenterology and Nutrition from Nationwide Children's Hospital.Amoxicillan-clavulanate, also known as Augmentin, is most commonly prescribed to treat or prevent infections caused by bacteria. However, it has also been reported to increase small bowel motility in healthy individuals and has been used to treat bacterial overgrowth in patients with chronic diarrhea.Upper gastrointestinal symptoms such as nausea, vomiting, abdominal pain, early satiety and abdominal distention are common in children. Despite the advances in the technology for diagnosing motility disorders, there continues to be a lack of medications available for the treatment of upper gastrointestinal tract motor function."There is a significant need for new drugs to treat upper gastrointestinal symptoms in children," said Carlo Di Lorenzo, MD, chief of Gastroenterology, Hepatology and Nutrition at Nationwide Children's Hospital and one of the study authors. "Currently used drugs are often only available on a restricted basis, have significant side effects or aren't effective enough on the small and large intestine."To examine whether amoxicillin-clavulanate might serve as a new option for treating upper gastrointestinal tract motor function, investigators at Nationwide Children's examined 20 patients who were scheduled to undergo antroduodenal manometry testing. After catheter placement, the team monitored each child's motility during fasting for at least three hours. The children then received one dose of amoxicillin-clavulanate enterally, either one hour before ingestion of a meal or one hour after the meal and then had motility monitored for one hour following.The study showed that amoxicillin-clavulanate triggered groups of propagated contractions within the small intestine, similar to those observed during the duodenal phase III of the interdigestive motility process. This response occurred in most of the study participants during the first 10-20 minutes and was most evident when amoxicillin-clavulanate was given before the meal."Inducing a preprandial duodenal phase III may accelerate small bowel transit, influence the gut microbiome and play a role in preventing the development of small bowel bacterial overgrowth," said Dr. Di Lorenzo.Dr. Di Lorenzo says that amoxicillin-clavulanate may be most effective in patients with alterations of duodenal phase III, chronic symptoms of intestinal pseudo-obstruction and those fed directly into the small bowel with gastrojejunal nasojejunal feeding tubes or surgical jejunostomy.Although amoxicillin-clavulanate seems to mainly affect the small bowel, the mechanisms by which it works are not clear. Dr. Di Lorenzo also says that possible downsides of using amoxicillin-clavulanate as a prokinetic agent include the induction of bacterial resistance, especially from gram negative bacteria such as E.coli and Klebsiella and causing Clostridium difficile induced colitis.Still, he says further investigation of amoxicillin-clavulanate's long-term benefits in gastrointestinal clinical situations is worthwhile. "The scarcity of currently available therapeutic options may justify the use of amoxicillin-clavulanate in selected patients with severe forms of small bowel dysmotility in whom other interventions have not been efficacious," he said.

May 7, 2012

Hmmm,

H is on amoxicillin at the moment. While it hasn't given him diarrhoea, it does

seem to have made him much more 'productive' - much more is coming out.

He is assumed to have poor motility - I think when he ws X-rayed at the C & W in

2008, having taken 3 sets of radioapaque markers, they were pretty well all

there 5 days later. Howver, he has made a lot of porgress since then - in 2008

he was simply soiling repeatedly rather than having BMs. Now the soiling is much

reduced and he has at least 1 BM a day.

But you wouldn't use amoxycillin long term just to improve motility, surely?

Margaret

>

> I recall Bradstreet saying that Augmentin is the about the only abx that

> still works for 'strep' (probably an umbrella term now) in autismŠ

>

> A treatment option for SIBO which has benefits beyond its antibacterial

> effect. More motility should equal less bacterial growth in the small

> intestine. If more motility can lead to a decrease in intestinal

> permeability, still needs to be determined. Resistance remains a problem,

> however.

>

> http://www.sciencedaily.com/releases...0430114945.htm

> <http://www.sciencedaily.com/releases/2012/04/120430114945.htm>

>

> ScienceDaily (Apr. 30, 2012) ‹ The common antibiotic,

> amoxicillin-clavulanate, may improve small bowel function in children

> experiencing motility disturbances, according to a study appearing in the

> June print edition of the Journal of Pediatric Gastroenterology and

> Nutrition from Nationwide Children's Hospital.

>

> Amoxicillan-clavulanate, also known as Augmentin, is most commonly

> prescribed to treat or prevent infections caused by bacteria. However, it

> has also been reported to increase small bowel motility in healthy

> individuals and has been used to treat bacterial overgrowth in patients with

> chronic diarrhea.

> Upper gastrointestinal symptoms such as nausea, vomiting, abdominal pain,

> early satiety and abdominal distention are common in children. Despite the

> advances in the technology for diagnosing motility disorders, there

> continues to be a lack of medications available for the treatment of upper

> gastrointestinal tract motor function.

> " There is a significant need for new drugs to treat upper gastrointestinal

> symptoms in children, " said Carlo Di Lorenzo, MD, chief of Gastroenterology,

> Hepatology and Nutrition at Nationwide Children's Hospital and one of the

> study authors. " Currently used drugs are often only available on a

> restricted basis, have significant side effects or aren't effective enough

> on the small and large intestine. "

> To examine whether amoxicillin-clavulanate might serve as a new option for

> treating upper gastrointestinal tract motor function, investigators at

> Nationwide Children's examined 20 patients who were scheduled to undergo

> antroduodenal manometry testing. After catheter placement, the team

> monitored each child's motility during fasting for at least three hours. The

> children then received one dose of amoxicillin-clavulanate enterally, either

> one hour before ingestion of a meal or one hour after the meal and then had

> motility monitored for one hour following.

> The study showed that amoxicillin-clavulanate triggered groups of propagated

> contractions within the small intestine, similar to those observed during

> the duodenal phase III of the interdigestive motility process. This response

> occurred in most of the study participants during the first 10-20 minutes

> and was most evident when amoxicillin-clavulanate was given before the meal.

> " Inducing a preprandial duodenal phase III may accelerate small bowel

> transit, influence the gut microbiome and play a role in preventing the

> development of small bowel bacterial overgrowth, " said Dr. Di Lorenzo.

> Dr. Di Lorenzo says that amoxicillin-clavulanate may be most effective in

> patients with alterations of duodenal phase III, chronic symptoms of

> intestinal pseudo-obstruction and those fed directly into the small bowel

> with gastrojejunal nasojejunal feeding tubes or surgical jejunostomy.

> Although amoxicillin-clavulanate seems to mainly affect the small bowel, the

> mechanisms by which it works are not clear. Dr. Di Lorenzo also says that

> possible downsides of using amoxicillin-clavulanate as a prokinetic agent

> include the induction of bacterial resistance, especially from gram negative

> bacteria such as E.coli and Klebsiella and causing Clostridium difficile

> induced colitis.

> Still, he says further investigation of amoxicillin-clavulanate's long-term

> benefits in gastrointestinal clinical situations is worthwhile. " The

> scarcity of currently available therapeutic options may justify the use of

> amoxicillin-clavulanate in selected patients with severe forms of small

> bowel dysmotility in whom other interventions have not been efficacious, " he

> said.

>

May 8, 2012

I know many many parents of pandas kids who've taken a big backslide on

Augmentin, going back to 2004 when I first started looking at this, I'm not

Bradstreet, I wish I was, just giving other side of argument.

Eileen