Comparison of in vitro activity of various macrolides against Helicobacter pylori

Clinical Microbiology and Antimicrobial Chemotherapy. 2018; 20(3):192-197

​ Dekhnich N.N., Ivanchik N.V., Kozlov R.S.
10.36488//cmac.2018.3.192-197
Helicobacter pylori antimicrobial resistance clarithromycin azithromycin jozamycin
Section
Antimicrobials
Type
Journal article
Publication
Clinical Microbiology and Antimicrobial Chemotherapy. 2018; 20(3):192-197

Objective.

Compare the in vitro activity of clarithromycin, erythromycin, azithromycin and josamycin against the collection of H. pylori strains isolated in 2010–2017 in Smolensk.

Materials and Methods.

H. pylori strains were collected prospectively from biopsy specimens of the gastric mucosa. Antimicrobial susceptibility testing of H. pylori was performed by the agar dilution method. Interpretation of the results of the susceptibility determination for clarithromycin was carried out in accordance with the recommendations of EUCAST (v 8.0) 2018. The resistance breakpoints for erythromycin, azithromycin, and josamycin were all set at ≥1.0 mg/L. For comparison of the results, the value of the minimal inhibitory concentrations of the tested antibiotic inhibiting the growth of 50% (MIC50) and 90% (MIC90) of H. pylori strains was used.

Results.

A total of 276 H. pylori strains were tested. 90% of the MIC values of clarithromycin were in the range from 0.015 to 0.125 mg/l. The percentages of resistance were as follows: clarithromycin 5.1%, azithromycin 7.5%, erythromycin 8%, josamycin 23.2%. Clarithromycin demonstrated significantly higher activity in suppressing the growth of H. pylori strains than azithromycin, erythromycin, and josamycin.

Conclusions.

Among the tested macrolide antibiotics maximal anti-H. pylori activity in vitro was observed in clarithromycin.

Natalya N. Dekhnich

Smolensk State Medical University, Smolensk, Russia

Nataly V. Ivanchik

Smolensk State Medical University, Smolensk, Russia

Roman S. Kozlov

Smolensk State Medical University, Smolensk, Russia

  • 1. Malfertheiner P., Megraud F., O’Morain C., et al. Management of Helicobacter pylori infection–Maastricht V/Florence consensus report. Gut. 2017;66(1):6-30.
  • 2. Sugano K., Tack J., Kuipers E.J., Graham D.Y., et al. Kyoto global consensus report on Helicobacter pylori gastritis. Gut. 2015;64:1-15.
  • 3. Li B.Z., Threapleton D.E., Wang J.Y., et al. Comparative effectiveness and tolerance of treatments for Helicobacter pylori: systematic review and network meta-analysis. BMJ 2015;351:h4052.
  • 4. Graham D.Y., Fischbach L. Helicobacter pylori treatment in the era of increasing antibiotic resistance. Gut. 2010;59:1143-1153.
  • 5. McMahon B.J., Hennessy T.W., Bensler J.M., et al. The relationship among previous antimicrobial use, antimicrobial resistance, and treatment outcomes for Helicobacter pylori infections. Ann Intern Med. 2003;139:463-469.
  • 6. Fischbach L., Evans E.L. Meta-analysis: the effect of antibiotic resistance status on the efficacy of triple and quadruple first-line therapies for Helicobacter pylori. Aliment Pharmacol Ther. 2007;26:343-357.
  • 7. Lim S.G., Park R.W., Shin S.J., et al. The relationship between the failure to eradicate Helicobacter pylori and previous antibiotics use. Dig Liver Dis. 2016;48:385-390.
  • 8. Horiki N., Omata F., Uemura M., et al. Annual change of primary resistance to clarithromycin among Helicobacter pylori isolates from 1996 through 2008 in Japan. Helicobacter. 2009;14:86-90.
  • 9. Li B.Z., Threapleton D.E., Wang J.Y., et al. Comparative effectiveness and tolerance of treatments for Helicobacter pylori: systematic review and network meta-analysis. BMJ. 2015;351:h4052.
  • 10. Malfertheiner P., Megraud F., O’Morain C.A., et al. Management of Helicobacter pylori infection-the Maastricht V/Florence Consensus Report. Gut. 2017;66:6-30.
  • 11. Xiao S.D., Liu W.Z., Hu P.J., et al. High cure rate of Helicobacterpylori infection using tripotassium dicitrato bismuthate, furazolidone and clarithromycin triple therapy for 1 week. Aliment Pharmacol Ther. 1999;13:311-315.
  • 12. Liu W.Z., Xiao S.D., Hu P.J., et al. A new quadruple therapy for Helicobacter pylori using tripotassium dicitrato bismuthate, furazolidone, josamycin and famotidine. Aliment Pharmacol Ther. 2000;14(11):1519-1522.
  • 13. Maev I.V., Vertkin A.L., Vovk E.I., et al. Josamycin combination with ranitidine in therapy of gastroduodenal ulcer: clinical efficiency. Klinicheskaia meditsina. 2000;3:46-50. Russian.
  • 14. Bordin D.S., Yanova O.B., Voinovan I.N., et al. Efficacy and safety of triple anti-Helicobacter bismuth-containing therapy: clarithromycin vs josamycin. Jeffektivnaja farmakoterapija. Gastrojenterologija. 2015;4(51):6-10. Russian.
  • 15. Baryshnikova N., Uspenskiy Y., Suvorov A. Efficacy and safety of triple eradication therapy with josamycin. 27th European Congress on Clinical Microbiology and Infectious Diseases. Vienna, Austria; 22-25 April 2017. EV0302.
  • 16. Kirika N.V., Bodrug N.I., Butorov I.V., Butorov S.I. Effectiveness of various anti-Helicobacter therapy regimens for duodenal ulcer. Terapevticheskij arhiv. 2004;2:18-22. Russian.
  • 17. Harrison J.D., Jones J.A., Morris D.L. Azithromycin levels in plasma and gastric tissue, juice and mucus. Eur J Clin Microbiol Infect Dis. 1991;10:862-864.
  • 18. Calabrese C., Di Febo G., Areni A., et al. Pantoprazole, azithromycin and tinidazole: short duration triple therapy for eradication of Helicobacter pylori infection. Aliment Pharmacol Ther. 2000;14:16131617.
  • 19. Bertoni G., Sassarelli R., Nigrisoli E., et al. Triple therapy with azithromycin, omeprazole and amoxycillin is highly effective in the eradication of Helicobacter pylori: a controlled trialversus omeprazole plus amoxycillin. Am J Gastroenterol. 1996;91:258-263.
  • 20. Caselli M, Trevisani L, Tursi A, et al. Short-term low-dose triple therapy with azithromycin, metronidazole and lansoprazole appears highly effective for the eradication of Helicobacter pylori. Eur J Gastroenterol Hepatol. 1997;9:45-48.
  • 21. Al-Assi M., Genta R.M., Karttunen T.J., et al. Azithromycin triple therapy for Helicobacter pylori infection: azithromycin, tetracycline and bismuth. Am J Gastroenterol. 1995;90:403-405.
  • 22. Esmaeili-Dooki M.R., Shirdel H., Hajiahmadi M. Eradication of Helicobacter pylori in children by triple therapy regimens of amoxicillin, omeprazole, and clarithromycin or azithromycin. Iran J Pediatr. 2015;25(6):e2360.
  • 23. Iwamoto A., Tanahashi T., Okada R., et al. Whole-genome sequencing of clarithromycin resistant Helicobacter pylori characterizes unidentified variants of multidrug resistant efflux pump genes. Gut Pathogens. 2014;6:27.
  • 24. Hirata K., Suzuki H., Nishizawa T., Tsugawa H., et al. Contribution of efflux pumps to clarithromycin resistance in Helicobacter pylori. J Gastroenterol Hepatol. 2010;25(Suppl. 1):75-79.
  • 25. Moiseyev S.V. Josamycin: distinctive features and perspectives of use. Klinicheskaja farmakologija i terapija. 2005;4:66-70. Russian.
  • 26. Maev I.V., Kucheryavy Y.A., Andreev D.N. Modern approaches to antihelicobacter therapy optimization. Lechashhij vrach. 2014;4:7379. Russian.
  • 27. Kozlov R.S., Ivanchik N.V., Dekhnich N.N. Recommendations for the isolation, identification and sensitivity of Helicobacter pylori to antibacterial drugs. Klinicheskaja mikrobiologija i antimikrobnaja himioterapija. 2014;16(3):181-185. Russian.
  • 28. The European Committee on Antimicrobial Susceptibility Testing. Breakpoint tables for interpretation of MICs and zone diameters. Version 8.0, 2018. www.eucast.org
  • 29. Seo J.H., Jun J.S., Yeom J.S., et al. Changing pattern of antibiotic resistance of Helicobacter pylori in children during 20 years in Jinju, South Korea. Pediatrics International. 2013;55:332-333.
  • 30. Shao Y., Lu R., Yang Y., et al. Antibiotic resistance of Helicobacter pylori to 16 antibiotics in clinical patients. J Clin Lab Anal. 2017;32(4):e22339.
  • 31. Liu D.S., Wang Y.H., Zeng Z.R., et al. Primary antibiotic resistance of Helicobacter pylori in Chinese patients: a multiregion prospective 7-year study. Clin Microbiol Infect. 2018;24(7):780.e5-780.e8.
  • 32. Malanoski G.J., Eliopoulos G.M., Ferraro M.J., et al. Effect of pH variation on the susceptibility of Helicobacter pylori to three macrolide antimicrobial agents and temafloxacin. Eur J Clin Microbiol Infect Dis. 1993:12;131-133.
  • 33. Malizia T., Tejada M., Marchetti F., et al. Synergic interactions of macrolides and proton-pump inhibitors against Helicobacter pylori: a comparative in-vitro study. J Antimicrob Chemother. 1998;41(Suppl. B):29-35.
  • 34. Fera M., Carbone M., Foca A. Activity of cefixime against Helicobacter pylori. International Journal of Antimicrobial Agents. 1993;3(2):105108.
Views
0 Abstract
0 PDF
0 Crossref citations
Shared