Potentiation of the action of metronidazole on Helicobacter pylori by omeprazole and bismuth subcitrate

Citation
Lp. Andersen et al., Potentiation of the action of metronidazole on Helicobacter pylori by omeprazole and bismuth subcitrate, INT J ANT A, 14(3), 2000, pp. 231-234
Citations number
21
Categorie Soggetti
Microbiology
Journal title
INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS
ISSN journal
09248579 → ACNP
Volume
14
Issue
3
Year of publication
2000
Pages
231 - 234
Database
ISI
SICI code
0924-8579(200004)14:3<231:POTAOM>2.0.ZU;2-G
Abstract
Treatment failures using triple therapy that include metronidazole, are com mon in patients infected with metronidazole-resistant Helicobacter pylori i n the gastric mucosa. Higher eradication rates in such patients have been d escribed when treatment regimens include bismuth salts compared to regimens that include proton pump inhibitors. In the present study, the synergistic effect of subinhibitory concentrations (0.25-0.5 MIC) of either bismuth su bcitrate or omeprazole with metronidazole on the susceptibility of 42 H. py lori strains was investigated by agar dilution method and the Epsilometer t est (Etest). With 0.5 MIC of either of the two drugs, the susceptibility of all H. pylori strains to metronidazole was reduced between two to 64 fold and six (27%) metronidazole-resistant strains (with MIC > 4 mg/l) reverted to being metronidazole sensitive. These results suggested that either bismu th salts or proton pump inhibitors may be effective in the treatment of som e infections with metronidazole-resistant H. pylori i strains when used in sufficiently high doses. (C) 2000 Elsevier Science B.V. and International S ociety of Chemotherapy. All rights reserved.