In vitro susceptibility of Helicobacter pylori to, and in vivo suppression by, 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 critically ill patients (using intravenous cefotaxime and topical polymyxin, tobramycin and amphotericin B (PTA) given by nasogastric tube) and all six volunteers (using PTA alone), H. 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 susceptible to polymyxin or amphotericin B.
van der Voort
P H
PH
Department of Intensive Care, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands. phjvdoort@wxs.nl
van der Hulst
R W
RW
Zandstra
D F
DF
van der Ende
A
A
Geraedts
A A
AA
Tytgat
G N
GN
D000287:Administration, Topical; D000666:Amphotericin B / Q000494:pharmacology / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000494:pharmacology* / Q000627:therapeutic use; D002439:Cefotaxime / Q000494:pharmacology / Q000627:therapeutic use; D002511:Cephalosporins / Q000494:pharmacology* / Q000627:therapeutic use; D003666:Decontamination / Q000379:methods; D004064:Digestive System / Q000187:drug effects; D004359:Drug Therapy, Combination / Q000494:pharmacology* / Q000627:therapeutic use; D016481:Helicobacter Infections / Q000188:drug therapy / Q000276:immunology; D016480:Helicobacter pylori / Q000187:drug effects* / Q000276:immunology; D006801:Humans; D008826:Microbial Sensitivity Tests / Q000379:methods; D011113:Polymyxins / Q000494:pharmacology / Q000627:therapeutic use; D014031:Tobramycin / Q000494:pharmacology / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D011113:Polymyxins; D000666:Amphotericin B; D002439:Cefotaxime; D014031:Tobramycin