In vitro activity of fosfomycin alone and in combination with amoxicillin, clarithromycin and metronidazole againstHelicobacter pyloricompared with combined clarithromycin and metronidazole.

Blacky, A.; Makristathis, A.; Apfalter, P.; Willinger, B.; Rotter, M. L.; Hirschl, A. M.

In order to evaluate the suitability of fosfomycin in combination with other agents for the treatment ofHelicobacter pyloriinfections, the susceptibility profiles of 65H. pyloristrains were determined against multiple antimicrobial agents and combinations thereof using the agar dilution method. For fosfomycin alone, the range of minimum inhibitory concentration (MIC) results and the MICs at which 50% and 90% of strains were inhibited were 0.5-32 µg/ml and 2 and 4 µg/ml, respectively. For the combination of fosfomycin with amoxicillin, clarithromycin or metronidazole, the means calculated for the minimum and maximum fractional inhibitory concentration index were 0.70-1.17 and 1.15-2.03, respectively, suggesting partial synergy or indifference in the majority of strains. The combination of clarithromycin and metronidazole showed synergistic activity against 14 of 28H. pyloristrains tested. The in vitro activity results suggest the combination of fosfomycin with either amoxicillin or clarithromycin may be a promising alternative for the treatment ofH. pyloriinfection. However, the clinical efficacy of these regimens remains to be investigated.

HELICOBACTER pylori infections; THERAPEUTICS; FOSFOMYCIN; AMOXICILLIN; METRONIDAZOLE; ANTIBACTERIAL agents; HELICOBACTER diseases; ANTIPARASITIC agents

European Journal of Clinical Microbiology & Infectious Diseases, 2005, Vol 24, Issue 4, p276

0934-9723

Academic Journal

10.1007/s10096-005-1307-9