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Journal of Antimicrobial Chemotherapy (1999) 43, 403-406
© 1999 The British Society for Antimicrobial Chemotherapy

Brief reports

In-vitro synergy of paromomycin with metronidazole alone or metronidazole plus hydroxymetronidazole against Helicobacter pylori

Joette M. Meyera, Seonyoung Ryub, Susan L. Pendlanda, Thomas P. Kanyokc and Larry H. Danzigera,*

a Department of Pharmacy Practice, College of Pharmacy, University of Illinois at Chicago, 833 South Wood Street, Chicago, IL 60612; USA; b Novartis Pharmaceuticals Corporation, East Hanover, NJ 07936, USA; c World Health Organization, Geneva, Switzerland

The in-vitro activities of paromomycin and metronidazole alone or paromomycin and metronidazole plus hydroxymetronidazole (2:1 ratio) were studied against 19 Helicobacter pylori isolates using an in-vitro chequerboard technique. Partial synergy was demonstrated for the majority of isolates (11/19) for both combinations tested. When hydroxymetronidazole was added to the parent compound, the number of metronidazole-sensitive isolates demonstrating synergy increased to 5/12, compared with 1/12 for the combination that did not include the metabolite. In metronidazole-resistant isolates there was a shift from an additive effect to partial synergy for the combination containing hydroxymetronidazole. The in-vitro activity of paromomycin and the synergic effect that is achieved in combination with metronidazole and hydroxymetronidazole render paromomycin suitable for further investigation as a treatment option for H. pylori infection.

* Corresponding author, Tel:+1-312-996-0892; Fax:+1-312-413-1797: E-mail: danziger{at}uic.edu


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