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ORIGINAL RESEARCH article
Front. Cell. Infect. Microbiol.
Sec. Antibiotic Resistance and New Antimicrobial drugs
Volume 14 - 2024 |
doi: 10.3389/fcimb.2024.1468645
Impact of Antibiotic Prophylaxis on Gut Microbiota in Colorectal Surgery: Insights from an Eastern European Stewardship Study
Provisionally accepted
Irina Cezara Văcărean-Trandafir
1*
Roxana Maria Amărandi
1*
Iuliu Cristian Ivanov
1
Loredana Mihaiela Dragoș
1
Mihaela Mențel
1
Ştefan Iacob
1,2
Ana Maria Muşină
1,2
Elena Roxana Bărgăoanu
1
Cristian Ene Roată
1,2
Stefan Morarasu
1,2
Valeri Țuțuianu
3
Marcel Ciobanu
3
Mihail Gabriel Dimofte
1,2- 1 Regional Institute of Oncology (IRO), Iasi, Romania
- 2 Grigore T. Popa University of Medicine and Pharmacy, Iași, Iasi, Romania
- 3 IMSP Institute of Oncology, Chisinau, Chisinau, Moldova
Antibiotic overuse is driving a global rise in antibiotic resistance, highlighting the need for robust antimicrobial stewardship (AMS) initiatives to improve prescription practices. While antimicrobials are essential for treating sepsis and preventing surgical site infections (SSIs), they can inadvertently disrupt the gut microbiota, leading to postoperative complications. Treatment methods vary widely across nations due to differences in drug choice, dosage, and therapy duration, affecting antibiotic resistance rates, which can reach up to 51% in some countries. In Romania and the Republic of Moldova, healthcare practices for surgical antibiotic prophylaxis differ significantly despite similarities in genetics, culture, and diet. Romania's stricter healthcare regulations result in more standardized antibiotic protocols, whereas Moldova's limited healthcare funding leads to less consistent practices and greater variability in treatment outcomes. This study presents the results of a prospective crossborder investigation involving 86 colorectal cancer patients from major oncological hospitals in Romania and Moldova. We analyzed fecal samples collected from patients before and 7 days postantibiotic treatment, focusing on the V3-V4 region of the 16S rRNA gene. Our findings indicate that inconsistent antibiotic prophylaxis policies-varying in type, dosage, or therapy durationsignificantly impacted the gut microbiota and led to more frequent dysbiosis compared to stricter prophylactic antibiotic practices (single dose, single product, limited time). We emphasize the need for standardized antibiotic prophylaxis protocols to minimize dysbiosis and its associated risks, promoting more effective antimicrobial use, particularly in low-and middle-income countries (LMICs).
Keywords: Gut Microbiota, CRC, Antibiotic therapy, 16S rRNA NGS, ASP, LIMCs
Received: 22 Jul 2024; Accepted: 18 Dec 2024.
Copyright: © 2024 Văcărean-Trandafir, Amărandi, Ivanov, Dragoș, Mențel, Iacob, Muşină, Bărgăoanu, Roată, Morarasu, Țuțuianu, Ciobanu and Dimofte. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Irina Cezara Văcărean-Trandafir, Regional Institute of Oncology (IRO), Iasi, Romania
Roxana Maria Amărandi, Regional Institute of Oncology (IRO), Iasi, Romania
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