Effects of In Vitro Antibiotic Resistance on Treatment: Bismuth-Containing Regimens
Bismuth compounds remain useful for Helicobacter pylori eradication therapy. These include colloidal bismuth subcitrate (CBS), bismuth subsalicylate (BSS) and, most recently, ranitidine bismuth citrate (RBC). CBS appears to prevent the development of imidazole resistance when coadministered with nit...
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2000-01-01
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Series: | Canadian Journal of Gastroenterology |
Online Access: | http://dx.doi.org/10.1155/2000/709640 |
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doaj-12ab54d8edb94210bb19f404d61367152020-11-24T21:42:08ZengHindawi LimitedCanadian Journal of Gastroenterology0835-79002000-01-01141088588910.1155/2000/709640Effects of In Vitro Antibiotic Resistance on Treatment: Bismuth-Containing RegimensNaoki Chiba0Surrey GI Clinic/Research, Guelph, and McMaster University, Hamilton, Ontario, CanadaBismuth compounds remain useful for Helicobacter pylori eradication therapy. These include colloidal bismuth subcitrate (CBS), bismuth subsalicylate (BSS) and, most recently, ranitidine bismuth citrate (RBC). CBS appears to prevent the development of imidazole resistance when coadministered with nitroimidazoles. Traditional triple therapy with bismuth, metronidazole and tetracycline or amoxicillin (BMT/A) only partially overcomes metronidazole resistance. However, the addition of a PPI to bismuth triple therapy largely overcomes established metronidazole resistance if treatment is given for at least one week or more. When RBC rather than PPI is used with clarithromycin, this dual regimen appears to be more effective in preventing the development of secondary clarithromycin resistance. The triple combination of RBC, metronidazole and clarithromycin appears to be effective against metronidazole resistant strains of H pylori. Thus, overall, there is some evidence that bismuth compounds may prevent the development of antibiotic resistance and that existing antibiotic resistance may at least be partially overcome in vitro and in vivo. With the growing emergence of H pylori resistance to metronidazole and clarithromycin, further research to clarify the role of bismuth compounds is required.http://dx.doi.org/10.1155/2000/709640 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Naoki Chiba |
spellingShingle |
Naoki Chiba Effects of In Vitro Antibiotic Resistance on Treatment: Bismuth-Containing Regimens Canadian Journal of Gastroenterology |
author_facet |
Naoki Chiba |
author_sort |
Naoki Chiba |
title |
Effects of In Vitro Antibiotic Resistance on Treatment: Bismuth-Containing Regimens |
title_short |
Effects of In Vitro Antibiotic Resistance on Treatment: Bismuth-Containing Regimens |
title_full |
Effects of In Vitro Antibiotic Resistance on Treatment: Bismuth-Containing Regimens |
title_fullStr |
Effects of In Vitro Antibiotic Resistance on Treatment: Bismuth-Containing Regimens |
title_full_unstemmed |
Effects of In Vitro Antibiotic Resistance on Treatment: Bismuth-Containing Regimens |
title_sort |
effects of in vitro antibiotic resistance on treatment: bismuth-containing regimens |
publisher |
Hindawi Limited |
series |
Canadian Journal of Gastroenterology |
issn |
0835-7900 |
publishDate |
2000-01-01 |
description |
Bismuth compounds remain useful for Helicobacter pylori eradication therapy. These include colloidal bismuth subcitrate (CBS), bismuth subsalicylate (BSS) and, most recently, ranitidine bismuth citrate (RBC). CBS appears to prevent the development of imidazole resistance when coadministered with nitroimidazoles. Traditional triple therapy with bismuth, metronidazole and tetracycline or amoxicillin (BMT/A) only partially overcomes metronidazole resistance. However, the addition of a PPI to bismuth triple therapy largely overcomes established metronidazole resistance if treatment is given for at least one week or more. When RBC rather than PPI is used with clarithromycin, this dual regimen appears to be more effective in preventing the development of secondary clarithromycin resistance. The triple combination of RBC, metronidazole and clarithromycin appears to be effective against metronidazole resistant strains of H pylori. Thus, overall, there is some evidence that bismuth compounds may prevent the development of antibiotic resistance and that existing antibiotic resistance may at least be partially overcome in vitro and in vivo. With the growing emergence of H pylori resistance to metronidazole and clarithromycin, further research to clarify the role of bismuth compounds is required. |
url |
http://dx.doi.org/10.1155/2000/709640 |
work_keys_str_mv |
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