In Vitro Sensitivity of Helicobacter pylori
Initial results indicate that long-term eradication of this Helicobacter pylori will be difficult. The first step in the search for a suitable antimicrobial to treat any infection is to determine the in vitro susceptibility of the causative organism to suitable therapeutic agents. The activity of a range of antimicrobial agents against H. pylori was first determined at neutral pH (Table 1) [1, 2]. H. pylori is highly sensitive to most of the β- lactams except cefsulodin. Penicillin, ampicillin, cefuroxime, cefoxitin and cephalexin have minimum inhibitory concentrations for 90% of organisms (MIC 90s) of less than 0.5 mg/litre; flucloxacillin and aztreonam are moderately active with MIC 90s of 2 mg/litre. The macrolides and quinolones except amifloxacin (MIC 90, 4 mg/litre) also have good activity with MIC 90s of less than 0.5 mg/litre. Other agents that have good in vitro activity include nitrofurantoin (MIC 90,0.5 mg/litre), gentamicin (MIC 90,0.25 mg/litre), tetracycline (MIC 90,0.25 mg/litre) and rifampicin (MIC 90,1 mg/ litre). Metronidazole has moderate activity but about 25% of strains are less sensitive . H. pylori is resistant to vancomycin, cefsulodin, trimethoprim and the sulphona- mides.
KeywordsGastric Mucus Subinhibitory Concentration Antral Gastritis Bismuth Subcitrate Bismuth Salt
Unable to display preview. Download preview PDF.
- 4.Gilman R, Leon-Barua R, Ramirez-Ramos A et al. (1986) Efficacy of nitrofurantoin in the treatment of antral gastritis associated with Campylobacter pyloridis. Gastroenterology 92:1405Google Scholar
- 7.Lamouliatte H, Megraud F, De Mascarel A et al. (1987) Placebo-controlled trial of josamycin in Campylobacter pyloridis associated gastritis. In: Kaijser B, Falsen E (eds) Campylobacter IV. Goterna, Goteborg, Sweden, pp:388–389Google Scholar
- 9.Hirschl AM, Stanek G, Rotter ML et al. (1988) Campylobacter pyloridis: frequency of occurrence, serology and susceptibility to antibiotics and ulcer-drugs. In: Kaijser B, Falsen E (eds) Campylobacter IV. Goterna, Goteborg, Sweden, pp:363–364Google Scholar
- 11.McNulty CAM (1989) Bacteriological and pharmacological basis for the treatment of Campylobacter pylori infection. In: Rathbone BJ, Heatley RV (eds) Campylobacter pylori and gastroduodenal disease. Blackwell, Oxford, pp:209–216Google Scholar
- 14.Hazell SL, Lee A (1985) The adaption of motile strains of Campylobacter pyloridis in gastric mucus and their association with gastric epithelial intercellular spaces abstract. Proceedings of the Third International Workshop on Campylobacter infections Ottawa, July 1985, Abstract No. 115:189–191Google Scholar
- 15.Allen A (1981) Structure and function of gastrointestinal mucus. In: Johnson LR (ed) Physiology of the gastrointestinal tract. Raven, New York.:617–639Google Scholar
- 17.Unge P, Gad A, Gnarpe H, Olsson J (1989) Does omeprazole improve antimicrobial therapy directed towards gastric Campylobacter pylori in patients with enteral gastritis. Proceedings of the Vth international workshop on Campylobacter infections. Mexico, Fuerta Vallarta, Febr 1989Google Scholar
- 18.Glupczynski Y, Burette A, Labbe M et al. (1988) Campylobacter pylori-associated gastritis: a double blind placebo-controlled trial with amoxycillin. Am J Gastroenterol 83:265–372Google Scholar