Influence of anti-Helicobacter triple-therapy with metronidazole, omeprazole and clarithromycin on intestinal microflora

Citation
A. Buhling et al., Influence of anti-Helicobacter triple-therapy with metronidazole, omeprazole and clarithromycin on intestinal microflora, ALIM PHARM, 15(9), 2001, pp. 1445-1452
Citations number
38
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Pharmacology,"da verificare
Journal title
ALIMENTARY PHARMACOLOGY & THERAPEUTICS
ISSN journal
0269-2813 → ACNP
Volume
15
Issue
9
Year of publication
2001
Pages
1445 - 1452
Database
ISI
SICI code
0269-2813(200109)15:9<1445:IOATWM>2.0.ZU;2-0
Abstract
Background: Proton pump inhibitor-based therapy including two antibiotics i s the treatment of choice for Helicobacter pylori infection. Oral antibioti c treatment can lead to intestinal overgrowth of potentially pathogenic bac teria, Aim: To investigate the intestinal microflora before and at different times after H. pylori treatment with omeprazole, clarithromycin and metronidazol e. Methods: Bacterial growth in faecal samples from 51 patients infected with H. pylori was determined qualitatively and quantitatively. During the same period of time, stool samples from 27 H. pylori-negative controls were take n and investigated at the same intervals. Results: The microflora of H. pylori-infected patients was different from t hat in H. pylori negative controls. It was characterized by a high concentr ation of lactobacilli, mainly Lactobacillus acidophilus. Immediately after therapy there was an increased colonization with yeasts, while the growth o f lactobacilli and other species was inhibited. Clostridium difficile was c ultured from three cases, but without clinical manifestations of pseudomemb ranous colitis. After 4 weeks of therapy, the microflora returned to normal and was not different from that of the H. pylori-negative control group. Conclusions: In H. pylori-positive patients the intestinal flora is charact erized by an increase in growth of acid-tolerant L. acidophilus. Eradicatio n therapy exerts only a short-term influence on intestinal flora, whereas i n the long term, the intestinal microflora is restored to a pattern similar to that of the control group.