AMOXICILLIN FOR THE TREATMENT OF HELICOBACTER-PYLORI INFECTION

Amoxicillin is one of the most active antimicrobials against Helicobac ter pylori in vitro, with a minimum inhibitory concentration (MIC) of less than or equal to 0.01-0.1 mg/l. Thus far, neither primary not sec ondary resistant strains have been found, Amoxicillin, which has a bac tericidal effect on H. pylori, but is less inhibitory in the stationar y growth phase and against cell-adherent or slowly growing H. pylori, probably has both topical and systemic activity. It is fairly acid sta ble and is less affected by gastric acidity than macrolides. Neverthel ess, its activity ill vivo is considerably enhanced when it is given c oncomitantly with proton pump inhibitors. Several amoxicillin-containi ng treatment regimes have yielded H. pylori eradication rates of great er than or equal to 90%. Of particular interest are 1-week treatment r egimens containing amoxicillin + clarithromycin + omeprazole, or amoxi cillin + metronidazole + omeprazole, as well as a 1-h topical therapy developed in Japan.