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Oral Antibiotics Attenuate Bowel Segment Reversal–Induced Systemic Inflammatory Response and Body Weight Loss in Massively Bowel-Resected Rats

Chien-Hsing Lee, MD^*,, Hui-Chen Lo, PhD^,, Ming-Chih Chou, MD, PhD and Huei-Ru Tsai, MS

From the ^* Division of Pediatric Surgery, Department of Surgery, Changhua Christian Hospital, Changhua, Taiwan; Intstitute of Medicine, Chung Shan Medical University, Taichung, Taiwan; Department of Medical Education and Research, Changhua Christian Hospital, Changhua, Taiwan; and the Department of Bioscience Technology, Chang Jung Christian University, Tainan, Taiwan

Correspondence: Hui-Chen Lo, PhD, Department of Medical Education and Research, Changhua Christian Hospital, 135 Nanhsia Street, Changhua 500, Taiwan. Electronic mail may be sent to 66161{at}cch.org.tw.

Background: Using a massively bowel-resected rat model, our previous study demonstrated that small bowel segment reversal stimulates jejunal hyperplasia but may also increase the possibility of bacterial translocation and the elevation of circulating white blood cells and serum interleukin-6 that may reduce the whole-body anabolism. The aim of this study is to investigate whether oral antibiotics might attenuate the inflammatory responses and might therefore facilitate the beneficial effects of bowel segment reversal. Methods: Male Wistar rats (270 g) underwent a 70% small bowel resection with (REV group) or without (CON group) a 3-cm small bowel segment reversal, or underwent a sham operation (SHAM group). After surgeries, half of the animals in the REV group were given oral clindamycin plus amoxicillin (50 plus 50 mg/kg/d, ANT group) for 3 weeks. Results: Oral antibiotics administration significantly attenuated the decreases in feeding efficiency (g of body weight/100 kcal diet) and increases in the circulation of white blood cells, serum nitric oxide, and interleukin-6 (1-way ANOVA, p < .05), which are associated with bowel segment reversal. In addition, antibiotics significantly increased serum concentrations of insulin-like growth factor-I, significantly decreased the total numbers of bacteria in the intestine, and tended to reduce the extent of jejunal hyperplasia in rats with bowel segment reversal. Conclusions: Our results suggest that oral antibiotics may be used as an adjuvant to attenuate the inflammatory responses and to enhance the anabolic responses in massively bowel-resected patients with bowel segment reversal.

Journal of Parenteral and Enteral Nutrition, Vol. 31, No. 5, 397-405 (2007)
DOI: 10.1177/0148607107031005397


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