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Journal of Antimicrobial Chemotherapy (2000) 46, 803-805
© 2000 The British Society for Antimicrobial Chemotherapy

Brief report

In vitro susceptibility of Helicobacter pylori to, and in vivo suppression by, antimicrobials used in selective decontamination of the digestive tract

Peter H. J. van der Voorta,b,*, René W. M. van der Hulstc,d, Durk F. Zandstraa, Arie van der Endee, Alfons A. M. Geraedtsf and Guido N. J. Tytgatc

a Department of Intensive Care, Onze Lieve Vrouwe Gasthuis, Amsterdam; b Department of Intensive Care, Medical Centre Leeuwarden-Zuid, Leeuwarden; c Department of Gastroenterology, Academic Medical Center, Amsterdam; d Department of Internal Medicine and Gastroenterology, Kennemer Gasthuis, Haarlem; e Department of Medical Microbiology, Academic Medical Center, Amsterdam and f Department of Gastroenterology, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands

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.

* Correspondence address. Department of Intensive care, Medical Centre Leeuwarden-Zuid, PO Box 888, 8901 BR Leeuwarden, The Netherlands. Tel: +31-58-2866777; Fax: +31-58-2866715; E-mail: phjvdvoort{at}wxs.nl


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