Sucralfate affects the susceptibility of Helicobacter pylori to antimicrobial agents.
BACKGROUND
Infection with Helicobacter pylori is regarded as a primary factor in the pathogenesis of gastric disease, and successful therapies now include a combination of antiulcer drugs with antimicrobial agents. In this study, we investigated the effect of sucralfate and omeprazole on the vitro anti-H. pylori activity of metronidazole, erythromycin, tetracycline, and amoxycillin.


METHODS
Aliquots of H. pylori culture were transferred to the wells containing different concentrations of antibiotics either alone or in the presence of various doses of sucralfate and omeprazole and incubated for 3 days for MIC evaluation.


RESULTS
The assays in the absence of sucralfate and omeprazole gave MIC value 0.10 mg/l for erythromycin, 0.12 mg/l for amoxycillin, 0.15 mg/l for tetracycline, and 14 mg/l for metronidazole. Inclusion of sucralfate evoked a 28% enhancement in the MIC of metronidazole, 2.5-fold in tetracycline, 8-fold in erythromycin, and 2-fold in amoxycillin. In the presence of omeprazole, the MIC of erythromycin improved 4-fold, tetracycline 1.6-fold, and amoxycillin, 2-fold.


CONCLUSIONS
The results demonstrate that sucralfate enhances the anti-H. pylori activity of antibiotics and that this effect is comparable to that of omeprazole.
Slomiany
B L
BL
Research Center, University of Medicine and Dentistry of New Jersey, Newark, USA.
Piotrowski
J
J
Majka
J
J
Slomiany
A
A
D000658:Amoxicillin / Q000494:pharmacology; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D000897:Anti-Ulcer Agents / Q000494:pharmacology*; D004347:Drug Interactions; D004917:Erythromycin / Q000494:pharmacology; D016480:Helicobacter pylori / Q000187:drug effects*; D006801:Humans; D008795:Metronidazole / Q000494:pharmacology; D008826:Microbial Sensitivity Tests; D009853:Omeprazole / Q000494:pharmacology; D010406:Penicillins / Q000494:pharmacology; D013392:Sucralfate / Q000494:pharmacology*; D013752:Tetracycline / Q000494:pharmacology
D000900:Anti-Bacterial Agents; D000897:Anti-Ulcer Agents; D010406:Penicillins; D008795:Metronidazole; D013392:Sucralfate; D004917:Erythromycin; D000658:Amoxicillin; D013752:Tetracycline; D009853:Omeprazole