Journal of Antimicrobial Chemotherapy, Vol 41, 29-35, Copyright © 1998 by The British Society for Antimicrobial Chemotherapy
T Malizia, M Tejada, F Marchetti, P Favini, G Pizzarelli, M Campa and S Senesi
Thirty-eight clinical strains of Helicobacter pylori were isolated from
patients with chronic gastritis and gastroduodenal ulceration, and their
susceptibility to macrolide antibiotics (roxithromycin, flurithromycin,
azithromycin, erythromycin) in combination with proton- pump inhibitors
(lansoprazole and omeprazole) and bismuth subcitrate was assayed.
Chequerboard titration was used to analyse the results of antimicrobial
interactions and showed that the activity of macrolides was enhanced by
combining them with lansoprazole, omeprazole or, to a lesser extent,
bismuth subcitrate. While the interactions between erythromycin and the
proton-pump inhibitors or bismuth subcitrate were always additive, the
combinations of roxithromycin-lansoprazole, flurithromycin-omeprazole and
azithromycin-lansoprazole acted synergically on 82%, 60% and 60% of H.
pylori strains, respectively. These results may, in part, account for the
enhanced clinical efficacy of macrolides administered with proton-pump
inhibitors in the treatment of H. pylori-associated diseases.
ORIGINAL ARTICLES
Synergic interactions of macrolides and proton-pump inhibitors against Helicobacter pylori: a comparative in-vitro study
Dipartimento di Biomedicina Sperimentale, Infettiva e Pubblica, Universita degli Studi di Pisa, Italy.
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