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Journal of Antimicrobial Chemotherapy (1996) 37, 483-489
© 1996 The British Society for Antimicrobial Chemotherapy

research-article

In-vitro activity of azithromycin against intracellular Helicobacter pylori

Kristina Hultén, Otto Cars, Eva Hjelm and Lars Engstrand

Department of Infectious Diseases and Clinical Microbiology, University Hospital Uppsala, Sweden

Received 20 January 1995; returned 5 April 1995; accepted 5 October 1995

We studied the effect in vitro of azithromycin on the clinical strain Helicobacter pylori H:72 growing intracellularly in monolayers of HEp-2 epithelial cells. After using gentamicin to eradicate extracellular bacteria, different concentrations of azithromycin were added to the infected cells and samples were taken after 0, 4, 8 and 24 h. Infected cells not exposed to antibiotic were included as controls. The MIC of azithromycin to the H. pylori was 0.25 mg/L and the MBC 0.5 mg/L in a broth dilution plate count method. A bactericidal effect was observed on intracellular H. pylori, with inhibition increasing with increasing azithromycin concentrations. However, extracellular concentrations of 200 x MBC were necessary to achieve intracellular killing . Our results show that azithromycin is active against intracellular H. pylori suggesting that it might be possible to exploit this activity when treating infections due to the organism.


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