Skip to main content
NCBI home page
Antimicrobial Agents and Chemotherapy logoLink to Antimicrobial Agents and Chemotherapy
. 1995 Dec;39(12):2641–2644. doi: 10.1128/aac.39.12.2641

Use of time-kill methodology to assess antimicrobial combinations against metronidazole-susceptible and metronidazole-resistant strains of Helicobacter pylori.

P E Coudron 1, C W Stratton 1
PMCID: PMC163004  PMID: 8592994

Abstract

Optimal therapy for Helicobacter pylori infection to date, consists of metronidazole, bismuth, and tetracycline. This combination, however, is less effective against metronidazole-resistant organisms. We used a time-kill kinetic methodology to assess the bactericidal effects of selected agents, alone and in combination, to a metronidazole-susceptible and a metronidazole-resistant strain of H. pylori. single, double, and triple agents showed increasing bactericidal activity. The combination of metronidazole, bismuth, and tetracycline showed maximal killing effect (no detectable regrowth) against the susceptible strain, but against the resistant strain this combination showed less killing. The time-kill methodology may therefore offer an in vitro approach to the initial selection of agents to be evaluated for the treatment of H. pylori infections.

Full Text

The Full Text of this article is available as a PDF (179.8 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bell G. D., Powell K., Burridge S. M., Pallecaros A., Jones P. H., Gant P. W., Harrison G., Trowell J. E. Experience with 'triple' anti-Helicobacter pylori eradication therapy: side effects and the importance of testing the pre-treatment bacterial isolate for metronidazole resistance. Aliment Pharmacol Ther. 1992 Aug;6(4):427–435. doi: 10.1111/j.1365-2036.1992.tb00556.x. [DOI] [PubMed] [Google Scholar]
  2. Blaser M. J. Helicobacter pylori: its role in disease. Clin Infect Dis. 1992 Sep;15(3):386–391. doi: 10.1093/clind/15.3.386. [DOI] [PubMed] [Google Scholar]
  3. Chiba N., Rao B. V., Rademaker J. W., Hunt R. H. Meta-analysis of the efficacy of antibiotic therapy in eradicating Helicobacter pylori. Am J Gastroenterol. 1992 Dec;87(12):1716–1727. [PubMed] [Google Scholar]
  4. Cooreman M. P., Krausgrill P., Hengels K. J. Local gastric and serum amoxicillin concentrations after different oral application forms. Antimicrob Agents Chemother. 1993 Jul;37(7):1506–1509. doi: 10.1128/aac.37.7.1506. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Coudron P. E., Kirby D. F. Comparison of rapid urease tests, staining techniques, and growth on different solid media for detection of Campylobacter pylori. J Clin Microbiol. 1989 Jul;27(7):1527–1530. doi: 10.1128/jcm.27.7.1527-1530.1989. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Coudron P. E., Stratton C. W. Utilization of time-kill kinetic methodologies for assessing the bactericidal activities of ampicillin and bismuth, alone and in combination, against Helicobacter pylori in stationary and logarithmic growth phases. Antimicrob Agents Chemother. 1995 Jan;39(1):66–69. doi: 10.1128/aac.39.1.66. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. DeCross A. J., Marshall B. J., McCallum R. W., Hoffman S. R., Barrett L. J., Guerrant R. L. Metronidazole susceptibility testing for Helicobacter pylori: comparison of disk, broth, and agar dilution methods and their clinical relevance. J Clin Microbiol. 1993 Aug;31(8):1971–1974. doi: 10.1128/jcm.31.8.1971-1974.1993. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Glupczynski Y., Burette A. Drug therapy for Helicobacter pylori infection: problems and pitfalls. Am J Gastroenterol. 1990 Dec;85(12):1545–1551. [PubMed] [Google Scholar]
  9. Graham D. Y., Börsch G. M. The who's and when's of therapy for Helicobacter pylori. Am J Gastroenterol. 1990 Dec;85(12):1552–1555. [PubMed] [Google Scholar]
  10. Graham D. Y., Lew G. M., Klein P. D., Evans D. G., Evans D. J., Jr, Saeed Z. A., Malaty H. M. Effect of treatment of Helicobacter pylori infection on the long-term recurrence of gastric or duodenal ulcer. A randomized, controlled study. Ann Intern Med. 1992 May 1;116(9):705–708. doi: 10.7326/0003-4819-116-9-705. [DOI] [PubMed] [Google Scholar]
  11. Graham D. Y., Lew G. M., Ramirez F. C., Genta R. M., Klein P. D., Malaty H. M. Short report: a non-metronidazole triple therapy for eradication of Helicobacter pylori infection--tetracycline, amoxicillin, bismuth. Aliment Pharmacol Ther. 1993 Feb;7(1):111–113. doi: 10.1111/j.1365-2036.1993.tb00076.x. [DOI] [PubMed] [Google Scholar]
  12. Hosking S. W., Ling T. K., Chung S. C., Yung M. Y., Cheng A. F., Sung J. J., Li A. K. Duodenal ulcer healing by eradication of Helicobacter pylori without anti-acid treatment: randomised controlled trial. Lancet. 1994 Feb 26;343(8896):508–510. doi: 10.1016/s0140-6736(94)91460-5. [DOI] [PubMed] [Google Scholar]
  13. Labenz J., Börsch G. Evidence for the essential role of Helicobacter pylori in gastric ulcer disease. Gut. 1994 Jan;35(1):19–22. doi: 10.1136/gut.35.1.19. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Marshall B. J. Treatment strategies for Helicobacter pylori infection. Gastroenterol Clin North Am. 1993 Mar;22(1):183–198. [PubMed] [Google Scholar]
  15. Pavicić M. J., Namavar F., Verboom T., van Winkelhoff A. J., De Graaff J. In vitro susceptibility of Helicobacter pylori to several antimicrobial combinations. Antimicrob Agents Chemother. 1993 May;37(5):1184–1186. doi: 10.1128/aac.37.5.1184. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Stratton C. W., Aldridge K. E., Gelfand M. S. In vitro killing of penicillin-susceptible, -intermediate, and -resistant strains of Streptococcus pneumoniae by cefotaxime, ceftriaxone, and ceftizoxime: a comparison of bactericidal and inhibitory activity with achievable CSF levels. Diagn Microbiol Infect Dis. 1995 May-Jun;22(1-2):35–42. doi: 10.1016/0732-8893(95)00094-q. [DOI] [PubMed] [Google Scholar]
  17. Sung J. J., Chung S. C., Ling T. K., Yung M. Y., Leung V. K., Ng E. K., Li M. K., Cheng A. F., Li A. K. Antibacterial treatment of gastric ulcers associated with Helicobacter pylori. N Engl J Med. 1995 Jan 19;332(3):139–142. doi: 10.1056/NEJM199501193320302. [DOI] [PubMed] [Google Scholar]
  18. Van Caekenberghe D. L., Breyssens J. In vitro synergistic activity between bismuth subcitrate and various antimicrobial agents against Campylobacter pyloridis (C. pylori). Antimicrob Agents Chemother. 1987 Sep;31(9):1429–1430. doi: 10.1128/aac.31.9.1429. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Antimicrobial Agents and Chemotherapy are provided here courtesy of American Society for Microbiology (ASM)

RESOURCES