Cholesterol Lowering, Fecal Bile Acid, and Sterol Changes during Neomycin and Colchicine

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Abstract
The effect of oral neomycin in large doses (6 g daily) upon serum cholesterol, fecal sterols, and bile acids was studied in three obese subjects and one hypocholesteremic cirrhotic patient. Four other obese subjects were studied similarly; two while they were given oral colchicine (2.4 mg daily) and two while receiving combined neomycin and colchicine. Coincident with decreases in serum cholesterol, fecal bile acid and sterol excretion rose during neomycin with reversal of the changes when it was withdrawn. The pattern of fecal excretion was also changed with a predominance of primary bile acid appearing and cholesterol replacing coprostanol during antibiotic administration. Colchicine also induced marked increases in fecal sterol and bile acids coincident with lowering of serum cholesterol, but serum triglyceride levels varied without relation to drug administration. Combined neomycin and colchicine therapy produced no clearcut additive effects. These results indicate a probable common mechanism of cholesterol lowering by neomycin and colchicine: interference with the enterohepatic cycle of bile acids and neutral sterols.