Metronidazole or Cotrimoxazole Therapy Is Associated with a Decrease in Intestinal Bioavailability of Common Antiretroviral Drugs: e89943

• Published in: PloS one Vol. 9; no. 2
• Main Authors: Dossou-Yovo, Flore, Mamadou, Godefroy, Soudy, Imar Djibrine, Limas-Nzouzi, Nicolas, Miantezila, Joe, Desjeux, Jehan-Francois, Eto, Bruno
• Format: Journal Article
• Language: English
• Published: 01.02.2014
• Subjects: Human immunodeficiency virus
• ISSN: 1932-6203
• DOI: 10.1371/journal.pone.0089943

Metronidazole (MTZ) and Cotrimoxazole (CTX) are used in HIV/AIDS patients eligible for antiretroviral treatment. The objective of this animal study was to determine whether pre-treatment with antibiotics affects the intestinal bioavailability of Atazanavir (ATV) and Ritonavir (RTV). After oral administration of 1 mg MTZ and CTX for 7 days, the rat colonic mucosa were analyzed for mucus thickness or placed in Ussing chambers to measure ATV and RTV net transepithelial fluxes (Jnet). 1. In control rats, the mucus thickness was 43.3 plus or minus 7.6 mu m and 40.7 plus or minus 6.9 mu m, in proximal and distal colon, respectively. In proximal colon, the thickness was 57.2 plus or minus 8.8 and 58.2 plus or minus 6.9 mu m after MTZ and CTX, respectively whereas in distal colon, the thickness was 121.1 plus or minus 38.4 and 170.5 plus or minus 35.0 mu m (P<0.05) respectively. 2. Transepithelial conductance was reduced after MTZ or CTX in the proximal and distal colon. 3. In control, net ATV secretion was observed both in proximal (-0.36 plus or minus 0.02 mu g.hr-1 cm-2) and distal colon (-0.30 plus or minus 0.08 mu g.hr-1 cm-2). After MTZ and CTX, it was increased in the proximal colon by two 2 fold and 4 fold, respectively and in the distal colon by 3 fold and 5 fold, respectively. 4. In control, there was no net active RTV transport either in proximal (+0.01 plus or minus 0.01 mu g.hr-1 cm-2) or distal colon (+0.04 plus or minus 0.01 mu g.hr-1 cm-2). After MTZ and CTX, secretion was increased 5 fold and 10 fold, respectively, in the proximal colon and two fold and 5 fold, respectively in the distal colon (p<0.001). In conclusion, after MTZ and CTX therapy, the mucus layer was enlarged, passive permeability was decreased and ATV and RTV were actively secreted by the colonic epithelium suggesting that, in rat, the intestinal bioavailability of ATV and RTV is impaired after antibiotic therapy.