The following are notes from a study that administered Activated Charcoal two hours BEFORE administration of an antibiotic, and then two additional times each day. By studying fecal samples of patients in the control and experimental group, they were able to show that the activated charcoal product, DAV132, reduced the amount of antibiotic that reached the intestines, but importantly, did not affect plasma levels of the medication. Each DAV132 dose contained about 5 grams of Activated Charcoal.
Here are some summarizing points:
Burgeoning research in recent years has shown that the intestinal microbiome plays an important role in many aspects of human physiology and health. In particular, it is involved in the production of metabolites that may affect insulin sensitivity and diet-related obesity; this state has been shown to correlate with a gut microbiome of lower bacterial richness than in healthy individuals.
Strategies that would preserve the intestinal microbiome from deleterious consequences of dysbiosis during antibiotic treatments would be highly welcome for immediate protection of patients from CDI, and also for long-term public health consequences such as dissemination of resistant bacteria and the occurrence of metabolic disorders.
Delivering a nonspecific adsorbent to the colon partially decreased fecal concentrations of orally administered ciprofloxacin without significantly affecting its plasma pharmacokinetics in rats. We devised a product, DAV132, which delivers a powerful nonspecific adsorbent, a carefully chosen activated charcoal, to the late ileum in humans, and have shown in healthy volunteers that its administration did not affect the plasma pharmacokinetics of amoxicillin, given as a single dose.
To assess whether DAV132 could also protect against antibiotics other than MXF routinely used in the clinic, we examined the capacity of the activated charcoal released from DAV132 to adsorb them under ex vivo conditions, that is, in pig cecal medium.
Among the 14 antibiotics routinely used in clinic tested, 13 were adsorbed to an extent of at least 95% by the charcoal after 3–5 hours of contact with deformulated DAV132. Only amoxicillin was a little less adsorbed, to the extent of 92%.
Our most important result was that in human volunteers treated with a clinical 5-day course of oral MXF, DAV132 spared the intestinal microbiome from exposure to free MXF by >99%, without affecting the plasma pharmacokinetics of the antibiotic or causing any serious adverse effects.
Our second most important result was that coadministration of DAV132 largely protected richness and composition of the intestinal microbiota of MXF-treated volunteers.
The changes observed with MXF alone that were maximal after 6 days of antibiotic, and persisted a month after the treatment ended, were reminiscent of those previously observed with ciprofloxacin. Under coadministration of DAV132 with MXF, they were largely reduced and return to baseline was observed 11 days after treatment ended, suggesting that long-term consequences of antibiotics might be spared.
A third important result from the study was that the adsorbent released from DAV132 could efficiently adsorb, under ex vivo conditions mimicking the cecum, antibiotics from several distinct and therapeutically important classes such as β-lactams of all categories (penicillins, cephalosporins, and carbapenems), fluoroquinolones, and lincosamides. This indeed suggests that the coadministration of DAV132 could protect the human gut microbiome against the deleterious effects of many antibiotics, including those administered orally, without affecting their plasma pharmacokinetics.
Reference:
de Gunzburg, J, et al. Protection of the Human Gut Microbiome From Antibiotics. J Infect Dis.2018 Feb 15; 217(4): 628–636.