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journal article Mar 01, 2016

Enteral but not parenteral antibiotics enhance gut function and prevent necrotizing enterocolitis in formula-fed newborn preterm pigs

Malene M. Birck Duc Ninh Nguyen ORCID Malene S. Cilieborg Shamrulazhar S. Kamal Dennis S. Nielsen Peter Damborg ORCID John E. Olsen Charlotte Lauridsen Per T. Sangild Thomas Thymann
American Journal of Physiology-Gastrointestinal and Liver Physiology Vol. 310 No. 5 pp. G323-G333 · American Physiological Society
View at Publisher Save 10.1152/ajpgi.00392.2015
Abstract
Preterm infants are susceptible to infection and necrotizing enterocolitis (NEC) and are often treated with antibiotics. Simultaneous administration of enteral and parenteral antibiotics during the first days after preterm birth prevents formula-induced NEC lesions in pigs, but it is unknown which administration route is most effective. We hypothesized that only enteral antibiotics suppress gut bacterial colonization and NEC progression in formula-fed preterm pigs. Caesarean-delivered preterm pigs (90–92% of gestation) were fed increasing amounts of infant formula from birth to day 5 and given saline (CON) or antibiotics (ampicillin, gentamicin, and metronidazole) via the enteral (ENT) or parenteral (PAR) route ( n = 16–17). NEC lesions, intestinal morphology, function, microbiology, and inflammatory mediators were evaluated. NEC lesions were completely prevented in ENT pigs, whereas there were high incidences of mild NEC lesions (59–63%) in CON and PAR pigs ( P < 0.001). ENT pigs had elevated intestinal weight, villus height/crypt depth ratio, and goblet cell density and reduced gut permeability, mucosal adherence of bacteria, IL-8 levels, colonic lactic acid levels, and density of Gram-positive bacteria, relative to CON pigs ( P < 0.05). Values in PAR pigs were intermediate with few affected parameters (reduced lactic acid levels and density and adherence of Gram-positive bacteria, relative to CON pigs, P < 0.05). There was no evidence of increased antimicrobial resistance following the treatments. We conclude that enteral, but not parenteral, administration of antibiotics reduces gut bacterial colonization, inflammation, and NEC lesions in newborn, formula-fed preterm pigs. Delayed colonization may support intestinal structure, function, and immunity in the immediate postnatal period of formula-fed preterm neonates.
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Cited By
57
Early antibiotics and risk for necrotizing enterocolitis in premature infants: A narrative review

Alain Cuna, Michael J. Morowitz · 2023

Frontiers in Pediatrics
The Role of the Microbiome in the Developmental Origins of Health and Disease

Leah T. Stiemsma, Karin B. Michels · 2018

Pediatrics
Metrics
57
Citations
46
References
Details
Published
Mar 01, 2016
Vol/Issue
310(5)
Pages
G323-G333
Authors
M
Malene M. Birck

Section of Comparative Pediatrics and Nutrition, Department of Veterinary Clinical and Animal Sciences, University of Copenhagen, Copenhagen, Denmark;

D
Duc Ninh Nguyen

Section of Comparative Pediatrics and Nutrition, Department of Veterinary Clinical and Animal Sciences, University of Copenhagen, Copenhagen, Denmark;

M
Malene S. Cilieborg

Section of Comparative Pediatrics and Nutrition, Department of Veterinary Clinical and Animal Sciences, University of Copenhagen, Copenhagen, Denmark;

S
Shamrulazhar S. Kamal

Department of Food Science, University of Copenhagen, Copenhagen, Denmark;

D
Dennis S. Nielsen

Department of Food Science, University of Copenhagen, Copenhagen, Denmark;

P
Peter Damborg

Department of Veterinary Disease Biology, University of Copenhagen, Copenhagen, Denmark;

J
John E. Olsen

Department of Veterinary Disease Biology, University of Copenhagen, Copenhagen, Denmark;

C
Charlotte Lauridsen

Department of Animal Science, Aarhus University, Arrhus, Denmark;

P
Per T. Sangild

Section of Comparative Pediatrics and Nutrition, Department of Veterinary Clinical and Animal Sciences, University of Copenhagen, Copenhagen, Denmark;; Department of Pediatrics and Adolescent Medicine, Rigshospitalet, Copenhagen, Denmark

T
Thomas Thymann

Section of Comparative Pediatrics and Nutrition, Department of Veterinary Clinical and Animal Sciences, University of Copenhagen, Copenhagen, Denmark;

Funding
The Strategic Research Council, Denmark
Cite This Article
Malene M. Birck, Duc Ninh Nguyen, Malene S. Cilieborg, et al. (2016). Enteral but not parenteral antibiotics enhance gut function and prevent necrotizing enterocolitis in formula-fed newborn preterm pigs. American Journal of Physiology-Gastrointestinal and Liver Physiology, 310(5), G323-G333. https://doi.org/10.1152/ajpgi.00392.2015
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