SUCRALFATE AFFECTS THE SUSCEPTIBILITY OF HELICOBACTER-PYLORI TO ANTIMICROBIAL AGENTS

Background: Infection with Helicobacter pylori is regarded as a primar y factor in the pathogenesis of gastric disease, and successful therap ies now include a combination of antiulcer drugs with antimicrobial ag ents. In this study, we investigated the effect of sucralfate and omep razole on the in vitro anti-H. pylori activity of metronidazole, eryth romycin, tetracycline, and amoxycillin. Methods: Aliquots of H. pylori culture were transferred to the wells containing different concentrat ions of antibiotics either alone or in the presence of various doses o f sucralfate and omeprazole and incubated for 3 days for MIC evaluatio n. Results: The assays in the absence of sucralfate and omeprazole gav e MIC value 0.10 mg/l for erythromycin, 0.12 mg/l for amoxycillin, 0.1 5 mg/l for tetracycline, and 14 mg/l for metronidazole. Inclusion of s ucralfate evoked a 28% enhancement in the MIC of metronidazole, 2.5-fo ld in tetracycline, 8-fold in erythromycin, and 2-fold in amoxycillin. In the presence of omeprazole, the MIC of erythromycin improved 4-fol d, tetracycline 1.6-fold, and amoxycillin, 2-fold. Conclusions: The re sults demonstrate that sucralfate enhances the anti-H. pylori activity of antibiotics and that this effect is comparable to that of omeprazo le.