In vitro Antagonism of Rabeprazole and Metronidazole upon Clinical Isolates of <i>Helicobacter pylori</i>

Vol. 55, No. 5, 2009

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Microbiology

In vitro Antagonism of Rabeprazole and Metronidazole upon Clinical Isolates of Helicobacter pylori
Alejandra Soto, Apolinaria García, Carlos L. González

Departamento de Microbiología, Facultad de Ciencias Biológicas, Universidad de Concepción, Concepción, Chile

Address of Corresponding Author

Chemotherapy 2009;55:308-311 (DOI: 10.1159/000226426)

Key Words

Antagonism
Rabeprazole
Metronidazole
Helicobacter

Abstract

Background: Rabeprazole inhibits Helicobacter pylori in vitro. This property could influence the antibacterial activity of metronidazole or amoxicillin. Our goal was to evaluate in vitrothe effect of rabeprazole upon the antibacterial activity of metronidazole and amoxicillin. Methods: The minimal inhibitory concentration (MIC) was determined by agar dilution upon 30 clinical isolates, and the antibacterial effect of the combined drugs was estimated by calculating the fractional inhibitory concentration index (FICI). Results: Nine strains (30%) were resistant to metronidazole (MIC 8–256 mg/l) while only 1 strain was resistant to amoxicillin (MIC 1.0 mg/l). Rabeprazole also inhibited H. pylori (MIC 0.125–1.0 mg/l). The association of metronidazole and rabeprazole showed synergism in 30% of the strains (FICI ≤0.25), but also antagonism in 23.3% of the clinical isolates (FICI ≥4.0). Mostly, amoxicillin-rabeprazole showed an effect of synergism (53.3%). Conclusion: The results presented suggest the need to keep in mind that failure in eradication therapies based on metronidazole and rabeprazole could be due to an antagonism of the drugs.

Author Contacts

Dr. Carlos L. González
Departamento de Microbiología, Facultad de Ciencias Biológicas
Universidad de Concepción
PO Box 160-C, Concepción (Chile)
Tel. +56 41 220 7478, Fax +56 41 224 5975, E-Mail carlosg@udec.cl

Article Information

Received: September 4, 2008
Accepted after revision: April 22, 2009
Published online: June 29, 2009
Number of Print Pages : 4
Number of Figures : 0, Number of Tables : 2, Number of References : 20

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