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Vancomycin treatment of infective endocarditis is linked with recently acquired obesity.

Thuny F, Richet H, Casalta JP, Angelakis E, Habib G, Raoult D - PLoS ONE (2010)

Bottom Line: Weight gain was particularly high in male patients older than 65 who did not undergo cardiac surgery.A major and significant weight gain can occur after a six-week intravenous treatment by vancomycin plus gentamycin for IE with a risk of obesity, especially in males older than 65 who have not undergone surgery.We speculate on the role of the gut colonization by Lactobacillus sp, a microorganism intrinsically resistant to vancomycin, used as a growth promoter in animals, and found at a high concentration in the feces of obese patients.

View Article: PubMed Central - PubMed

Affiliation: Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes, Université de la Méditerranée, Marseille, France.

ABSTRACT

Background: Gut microbiota play a major role in digestion and energy conversion of nutrients. Antibiotics, such as avoparcin (a vancomycin analogue), and probiotics, such as Lactobacillus species, have been used to increase weight in farm animals. We tested the effect of antibiotics given for infective endocarditis (IE) on weight gain (WG).

Methodology/principal findings: Forty-eight adults with a definite diagnosis of bacterial IE (antibiotic group) were compared with forty-eight age-matched controls without IE. Their body mass index (BMI) was collected at one month before the first symptoms and one year after hospital discharge. The BMI increased significantly and strongly in vancomycin-plus-gentamycin-treated patients (mean [+/-SE] kg/m(2), +2.3 [0.9], p = 0.03), but not in controls or in patients treated with other antibiotics. Seventeen patients had a BMI increase of >or=10%, and five of the antibiotic group developed obesity. The treatment by vancomycin-plus-gentamycin was an independent predictor of BMI increase of >or=10% (adjusted OR, 6.7; 95% CI, 1.37-33.0; p = 0.02), but not treatment with other antibiotics. Weight gain was particularly high in male patients older than 65 who did not undergo cardiac surgery. Indeed, all three vancomycin-treated patients with these characteristics developed obesity.

Conclusions/significance: A major and significant weight gain can occur after a six-week intravenous treatment by vancomycin plus gentamycin for IE with a risk of obesity, especially in males older than 65 who have not undergone surgery. We speculate on the role of the gut colonization by Lactobacillus sp, a microorganism intrinsically resistant to vancomycin, used as a growth promoter in animals, and found at a high concentration in the feces of obese patients. Thus, nutritional programs and weight follow-up should be utilized in patients under such treatment.

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Percentage of patients with a major increase (≥10%) of body mass index (BMI), defined as an increase.
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pone-0009074-g002: Percentage of patients with a major increase (≥10%) of body mass index (BMI), defined as an increase.

Mentions: Seventeen patients had a BMI increase of ≥10%: 16 (33.3%) in the Antibiotic group and only one (2.1%) in the control group (p<0.0001). This major increase of BMI was observed at a rate of 63.4% after treatment with vancomycin+gentamycin, 25% after treatment with amoxicillin+gentamycin, and 22.2% after treatment with other antibiotics (p<0.0001). The rate of BMI increase ≥10% was significantly higher after vancomycin+gentamycin treatment than in controls (p<0.0001) or after a treatment by amoxicillin+gentamycin (p = 0.02) or other antibiotics (p = 0.06) (Figure 2). Among all 96 patients assessed, five developed obesity, defined as a new BMI >30 Kg/m2 after an increase of their BMI ≥10%. Three of those had been treated with vancomycin+gentamycin and two with amoxicillin+gentamycin.


Vancomycin treatment of infective endocarditis is linked with recently acquired obesity.

Thuny F, Richet H, Casalta JP, Angelakis E, Habib G, Raoult D - PLoS ONE (2010)

Percentage of patients with a major increase (≥10%) of body mass index (BMI), defined as an increase.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2818846&req=5

pone-0009074-g002: Percentage of patients with a major increase (≥10%) of body mass index (BMI), defined as an increase.
Mentions: Seventeen patients had a BMI increase of ≥10%: 16 (33.3%) in the Antibiotic group and only one (2.1%) in the control group (p<0.0001). This major increase of BMI was observed at a rate of 63.4% after treatment with vancomycin+gentamycin, 25% after treatment with amoxicillin+gentamycin, and 22.2% after treatment with other antibiotics (p<0.0001). The rate of BMI increase ≥10% was significantly higher after vancomycin+gentamycin treatment than in controls (p<0.0001) or after a treatment by amoxicillin+gentamycin (p = 0.02) or other antibiotics (p = 0.06) (Figure 2). Among all 96 patients assessed, five developed obesity, defined as a new BMI >30 Kg/m2 after an increase of their BMI ≥10%. Three of those had been treated with vancomycin+gentamycin and two with amoxicillin+gentamycin.

Bottom Line: Weight gain was particularly high in male patients older than 65 who did not undergo cardiac surgery.A major and significant weight gain can occur after a six-week intravenous treatment by vancomycin plus gentamycin for IE with a risk of obesity, especially in males older than 65 who have not undergone surgery.We speculate on the role of the gut colonization by Lactobacillus sp, a microorganism intrinsically resistant to vancomycin, used as a growth promoter in animals, and found at a high concentration in the feces of obese patients.

View Article: PubMed Central - PubMed

Affiliation: Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes, Université de la Méditerranée, Marseille, France.

ABSTRACT

Background: Gut microbiota play a major role in digestion and energy conversion of nutrients. Antibiotics, such as avoparcin (a vancomycin analogue), and probiotics, such as Lactobacillus species, have been used to increase weight in farm animals. We tested the effect of antibiotics given for infective endocarditis (IE) on weight gain (WG).

Methodology/principal findings: Forty-eight adults with a definite diagnosis of bacterial IE (antibiotic group) were compared with forty-eight age-matched controls without IE. Their body mass index (BMI) was collected at one month before the first symptoms and one year after hospital discharge. The BMI increased significantly and strongly in vancomycin-plus-gentamycin-treated patients (mean [+/-SE] kg/m(2), +2.3 [0.9], p = 0.03), but not in controls or in patients treated with other antibiotics. Seventeen patients had a BMI increase of >or=10%, and five of the antibiotic group developed obesity. The treatment by vancomycin-plus-gentamycin was an independent predictor of BMI increase of >or=10% (adjusted OR, 6.7; 95% CI, 1.37-33.0; p = 0.02), but not treatment with other antibiotics. Weight gain was particularly high in male patients older than 65 who did not undergo cardiac surgery. Indeed, all three vancomycin-treated patients with these characteristics developed obesity.

Conclusions/significance: A major and significant weight gain can occur after a six-week intravenous treatment by vancomycin plus gentamycin for IE with a risk of obesity, especially in males older than 65 who have not undergone surgery. We speculate on the role of the gut colonization by Lactobacillus sp, a microorganism intrinsically resistant to vancomycin, used as a growth promoter in animals, and found at a high concentration in the feces of obese patients. Thus, nutritional programs and weight follow-up should be utilized in patients under such treatment.

Show MeSH
Related in: MedlinePlus