Infect Chemother.  2019 Mar;51(1):10-20. 10.3947/ic.2019.51.1.10.

Can Aminoglycosides Be Used as a New Treatment for Helicobacter pylori? In vitro Activity of Recently Isolated Helicobacter pylori

• Lee KH
• Park SY
• Jeong SJ
• Jung DH
• Kim JH
• Jeong SH
• Kang IM
• Song YG

• KMID: 2442217
• DOI: http://doi.org/10.3947/ic.2019.51.1.10

Abstract

BACKGROUND
Smectite can serve as a drug delivery system and gentamicin-intercalated smectite hybrids are expected to supersede the standard therapy for Helicobacter pylori eradication. The aim of this study was to confirm whether the minimum inhibitory concentration (MIC) of aminoglycosides applied as smectite hybrids remained low against recently isolated H. pylori strains.
MATERIALS AND METHODS
A total of 140 strains were collected for a minimum period of 3 years. Antimicrobial susceptibility tests were performed, and the MICs of eight antibiotics (amoxicillin, clarithromycin, metronidazole, tetracycline, levofloxacin, gentamicin, netilmicin, and tobramycin) were determined by using the Epsilometer test and following the European Committee on Antimicrobial Susceptibility Testing recommendations.
RESULTS
The resistance rate of clarithromycin was high, up to 30.7%, although it is a major antimicrobial agent used in standard therapy. The MIC50 and MIC90 of gentamicin (0.25 mg/L and 0.75 mg/L) and netilmicin (0.19 mg/L and 0.75 mg/L) were lower than other alternative therapies for H. pylori eradication. In clarithromycin-resistant strains, the MIC50 was 0.25 mg/L and the MIC90 was 1 mg/L for gentamicin; for netilmicin, the values were 0.25 mg/L and 0.75 mg/L, respectively.
CONCLUSION
Through the use of gentamicin and netilmicin, which have low MICs for H. pylori, aminoglycoside-intercalated smectite hybrids are expected to emerge as a new standard therapy for H. pylori eradication.

Keyword

Helicobacter pylori; Clarithromycin; Aminoglycosides

MeSH Terms

Aminoglycosides*
Anti-Bacterial Agents
Clarithromycin
Complementary Therapies
Disk Diffusion Antimicrobial Tests
Drug Delivery Systems
Gentamicins
Helicobacter pylori*
Helicobacter*
In Vitro Techniques*
Levofloxacin
Metronidazole
Microbial Sensitivity Tests
Netilmicin
Tetracycline
Aminoglycosides
Anti-Bacterial Agents
Clarithromycin
Gentamicins
Metronidazole
Netilmicin
Tetracycline

Figure

• 

  Figure 1 Minimum inhibitory concentration distributions of various antibiotics against Helicobacter pylori isolates. The dotted line represents the breakpoint in each antibiotic. Resistance break points for MICs against Helicobacter pylori were defined based on the recommendations of the European Committee on Antimicrobial Susceptibility Testing. For aminoglycosides, breakpoints for H. pylori have not been previously studied; therefore, strict breakpoints >1 mg/L have been applied. MIC, minimum inhibitory concentration; AMX, amoxicillin; CLR, clarithromycin; MDZ, metronidazole; TET, tetracycline; LVX, levofloxacin; GEN, gentamicin; NET, netilmicin; TOB, tobramycin.

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