tetracycline and Achlorhydria

The role of bacteria in the bioavailability of protein-bound vitamin B12 was examined in eight elderly subjects who had atrophic gastritis and in eight normal controls. On separate days and in random order, vitamin B12 absorption tests were performed using either radiolabeled crystalline or protein-bound vitamin B12. At the same time, bacterial samples were collected from the upper gastrointestinal tract. The tests and gastrointestinal aspirates were performed before and during tetracycline therapy. Crystalline vitamin B12 was absorbed to the same extent in the two study groups. Atrophic gastritis subjects absorbed significantly less protein-bound vitamin B12 than normal controls (mean +/- SEM, 0.7% +/- 0.2% vs. 1.9% +/- 0.5%, respectively). However, protein-bound vitamin B12 absorption in these subjects normalized after antibiotic therapy. These results suggest that the small amounts of vitamin B12 released from the protein binders is readily absorbed (as shown in vitro) and/or metabolized by bacteria.

Topics: Achlorhydria; Aged; Bacterial Infections; Biological Availability; Female; Gastritis, Atrophic; Humans; Intestinal Absorption; Male; Tetracycline; Transcobalamins; Vitamin B 12; Vitamin B 12 Deficiency

An 83-year-old male presented with chronic diarrhea and protein malnutrition associated with Plesiomonas shigelloides overgrowth in the small intestine. This overgrowth was related to achlorhydria and small-bowel diverticula. Tests for heat-labile and heat-stable enterotoxin were negative on the P. shigelloides isolated from both the small bowel aspirate (3 x 10(8) bacteria per ml) and the patient's stool. The patient responded satisfactorily to tetracycline, to which this unusual isolate was susceptible in vitro. The ability to correctly identify and determine the antimicrobial susceptibility of P. shigelloides in the setting of small-bowel overgrowth will help determine appropriate therapy.

Topics: Achlorhydria; Aged; Chronic Disease; Diarrhea; Diverticulum; Feces; Humans; Intestine, Small; Male; Microbial Sensitivity Tests; Protein Deficiency; Tetracycline; Vibrionaceae

Five elderly achlorhydric patients and five controls took 250 mg tetracycline as a capsule or as an oral solution. Venous blood samples drawn during the 12-hr period following administration and urine collected for 72 hr post-dosing were assayed fluorometrically for tetracycline. There were no differences between the two groups in either rate or extent of tetracycline absorption. The mean apparent first-order rate constant (ka) for absorption of drug from capsules was 0.58 +/- 0.17 hr-1 for patients and 0.65 +/- 0.21 hr-1 for controls. The mean extent of absorption for capsule dosage forms relative to an oral solution was 1.0 +/- 0.20 for patients and 1.0 +/- 0.24 for controls. Concurrent administration of 2 gm of sodium bicarbonate to 2 of the normal subjects resulted in no impairment of either the rate or extent of tetracycline absorption from capsules, suggesting that the effect of elevated gastric pH on tetracycline bioavailability may relate to formulation.

Topics: Achlorhydria; Administration, Oral; Adult; Aged; Bicarbonates; Biological Availability; Capsules; Female; Humans; Intestinal Absorption; Kinetics; Male; Middle Aged; Solutions; Tetracycline

Idiopathic late-onset immunoglobulin deficiency in a young man was associated with achlorhydria and a severe intestinal malabsorption syndrome that did not respond to conventional therapy. Combined therapy with high doses of prednisone and tetracycline hydrochloride resulted in weight gain, cessation of diarrhea, improved absorption of water, fat, and vitamin B12, and production of gastric acid after stimulation with histamine. Serum immunoglobulin levels, however, did not increase.

Topics: Achlorhydria; Adult; Age Factors; Body Weight; Celiac Disease; Cholecystokinin; Diarrhea; Drug Therapy, Combination; Humans; Immunoglobulin M; Immunologic Deficiency Syndromes; Malabsorption Syndromes; Male; Prednisone; Tetracycline; Vitamin B 12

Topics: Achlorhydria; Anemia, Megaloblastic; Anorexia Nervosa; Body Weight; Bone Marrow Cells; Celiac Disease; Diarrhea; Gastritis; Hemoglobinometry; Humans; Jejunum; Malabsorption Syndromes; Sprue, Tropical; Tetracycline; Vitamin B 12; Zimbabwe

Topics: Achlorhydria; Adult; Aged; Anemia, Macrocytic; Anemia, Pernicious; Antibodies; Erythrocyte Count; Folic Acid; Histamine; Humans; Intrinsic Factor; Malabsorption Syndromes; Middle Aged; Pentagastrin; Reticulocytes; Schilling Test; South Africa; Stimulation, Chemical; Syndrome; Tetracycline; Vitamin B 12

Topics: Achlorhydria; Adult; Aged; Alkalies; Bacterial Infections; Celiac Disease; Diabetes Complications; Diabetic Neuropathies; Diarrhea; Drug Synergism; Female; Humans; Male; Middle Aged; Parasympatholytics; Potassium; Salts; Solutions; Tetracycline

Topics: Achlorhydria; Animals; Anti-Bacterial Agents; Chlortetracycline; Depression, Chemical; Digestion; Eucalyptus; Gastric Juice; Haplorhini; Male; Oleandomycin; Oxytetracycline; Penicillins; Plant Extracts; Plants, Medicinal; Proteins; Tetracycline

Topics: Achlorhydria; Ascites; Bile; Biomedical Research; Body Fluids; Duodenal Ulcer; Fluorescence; Gastric Lavage; Hernia, Diaphragmatic; Humans; Leiomyosarcoma; Lymphoma; Lymphoma, Non-Hodgkin; Neoplasms; Pancreatic Juice; Pleural Effusion; Polyps; Secretin; Stomach; Stomach Neoplasms; Stomach Ulcer; Tetracycline