Comparative efficacy of new investigational agents against Helicobacter pylori

Citation
Ms. Osato et al., Comparative efficacy of new investigational agents against Helicobacter pylori, ALIM PHARM, 15(4), 2001, pp. 487-492
Citations number
33
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Pharmacology,"da verificare
Journal title
ALIMENTARY PHARMACOLOGY & THERAPEUTICS
ISSN journal
0269-2813 → ACNP
Volume
15
Issue
4
Year of publication
2001
Pages
487 - 492
Database
ISI
SICI code
0269-2813(200104)15:4<487:CEONIA>2.0.ZU;2-6
Abstract
Background: Emergence of antibiotic resistant Helicobacter pylori has neces sitated the identification of alternate therapies for the treatment of this infection. Aim: To assess the in vitro efficacy of two investigational agents: DMG-MIN O CL 344 (a N,N-dimethylglycylamido derivative of minocycline), and daverci n, a cyclic carbonate of erythromycin A as compared to older antibiotics (c larithromcyin, azithromycin, minocycline, tetracycline, ofloxacin, ciproflo xacin, cefixime) against clinical isolates of H. pylori. Methods: Testing was performed using the agar dilution method approved by t he NCCLS subcommittee on antimicrobial susceptibility testing, Helicobacter pylori working group. Under these guidelines, Mueller-Hinton agar containi ng 5% aged sheep blood was used. All incubations were done under CampyPak P lus conditions for 72 h at 37 degreesC, The drug concentrations in the agar ranged from 0.016 to 16 mug/mL. Twenty-one clarithromycin-resistant and 16 clarithromycin-susceptible clinical isolates of H. pylori obtained from pa tients with duodenal ulcer were used. H. pylori ATCC 43504 was used as the control in all determinations. Results: Against clarithromycin susceptible isolates, all antimicrobial age nts except the fluoroquinolones were highly effective. Against clarithromyc in-resistant H. pylori, the MIC50/MIC90 values showed that the tetracycline s and cefixime were the most efficacious agents. The fluoroquinolones and m acrolides were ineffective, Macrolide cross-resistance was detected. Conclusion: Macrolide cross-resistance prevents the use of this entire clas s of antimicrobials when clarithromycin resistance is present. Tetracycline s and cefixime are possible alternative agents for the treatment of H. pylo ri infection in these patients.