Background: Maintaining gastrointestinal (GI) microbiome diversity plays a key role during allogeneic stem cell transplantation (ASCT), and loss of diversity correlates with acute GI graft versus host disease (GvHD) and poor outcomes VSports手机版. .

Methods: In this retrospective analysis of 161 ASCT patients, we used serial analyses of urinary 3-indoxyl sulfate (3-IS) levels and GI microbiome parameters within the first 10 days after ASCT to identify potential commensal microbiota-sparing antibiotics. Based on antibiotic activity, we formed 3 subgroups (Rifaximin without systemic antibiotics, Rifaximin with systemic antibiotics, and Ciprofloxacin/Metronidazole with/without systemic antibiotics). V体育安卓版.

Results: Mono-antibiosis with Rifaximin revealed higher 3-IS levels (P < . 001), higher Clostridium cluster XIVa (CCXIVa) abundance (P = . 004), and higher Shannon indices (P = . 01) compared to Ciprofloxacin/Metronidazole with/without systemic antibiotics. Rifaximin followed by systemic antibiotics maintained microbiome diversity compared to Ciprofloxacin/Metronidazole with/without systemic antibiotics, as these patients showed still higher 3-IS levels (P = . 04), higher CCXIVa copy numbers (P = . 01), and higher Shannon indexes (P = . 01). Even for this larger cohort of patients, the outcome was superior with regard to GI GvHD (P = . 05) and lower transplant-related mortality (P < . 001) for patients receiving Rifaximin plus systemic antibiotics compared to other types of systemic antibiotic treatment. Antibiosis with Ciprofloxacin/Metronidazole (n = 12, P = . 01), Piperacillin/Tazobactam (n = 52, P = . 01), Meropenem/Vancomycin (n = 16, P = . 003), Ceftazidime (n = 10, P = V体育ios版. 03), or multiple systemic antibiotics (n = 53, P = . 001) showed significantly lower 3-IS levels compared to mono-antibiosis with Rifaximin (n = 14) or intravenous Vancomycin (n = 4, not statistically significant). .

Conclusions: Different types of antibiotic treatments show different impacts on markers of microbiome diversity. The identification of antibiotics sparing commensal bacteria remains an ongoing challenge. However, Rifaximin allowed a higher intestinal microbiome diversity, even in the presence of systemic broad-spectrum antibiotics VSports最新版本. .