In vitro susceptibility of Helicobacter pylori to, and in vivo suppressionby, antimicrobials used in selective decontamination of the digestive tract

The incidence of bleeding related to stress ulcers is reduced in critically ill patients in whom gut decontamination has been performed; this may be a result of suppression of Helicobacter pylori infection. We determined the susceptibility of H. pylori to the applied antibiotics. In nine of 10 criti cally ill patients (using intravenous cefotaxime and topical polymyxin, tob ramycin and amphotericin B (PTA) given by nasogastric tube) and all six vol unteers (using PTA alone), ii. pylori was suppressed as long as the topical antibiotics were ingested. The in vitro studies revealed that all strains were susceptible to cefotaxime and tobramycin. The strains were not suscept ible to polymyxin or amphotericin B.