One side-effect of the
therapeutic use of
antimicrobial agents is
respiratory paralysis as a result of inhibition of skeletal neuromuscular transmission;
cholinergic neuro-effector motor transmission in the gastrointestinal tract is inhibited by the same classes of
antimicrobial agent. Study of the effects of several classes of
antibiotic compound on intestinal motility has suggested that
antibiotic-induced alterations of intestinal motility may be related to the onset of diarrhoea or the development of
antibiotic-associated colitis. These compounds may, however, also initiate or exacerbate diarrhoea by altering control of epithelial function, a possibility that has not previously been rigorously investigated. This series of experiments investigated the effect of six
antibiotics on rabbit distal colonic epithelial ion transport. Of all the
antibiotics studied, only
ampicillin was without effect.
Clindamycin,
erythromycin,
gentamicin and
lincomycin, each reduced the response of the epithelium to electrical field stimulation. In addition, the
lincosamides clindamycin and
lincomycin reduced basal short circuit current and the epithelial response to
acetylcholine.
Vancomycin had no effect on the response to electrical field stimulation or
acetylcholine but enhanced the secretory action of
prostaglandin E2. These data suggest that, in addition to their ability to alter intestinal motility, a number of potential
antibiotic interactions with the epithelium and its innervation may contribute to the pathogenesis of
antibiotic-associated diarrhoea and
colitis.