Prevention of nitroimidazole resistance in Campylobacter pylori by coadministration of colloidal bismuth subcitrate: Clinical and in vitro studies

C. S. Goodwin, B. J. Marshall, E. D. Blincow, D. H. Wilson, S. Blackbourn, M. Phillips

Research output: Contribution to journalArticle

179 Citations (Scopus)

Abstract

One hundred patients with duodenal ulceration and Campylobacter pylori in their stomach were entered into a double blind placebo controlled prospective study. Treatment schedules were cimetidine and placebo, or cimetidine and tinidazole, or colloidal bismuth subcitrate (CBS) and placebo, or CBS and tinidazole. Seventeen per cent of isolates of C pylori obtained at the first endoscopy were resistant to tinidazole and 70% of the second isolates from patients given cimetidine and tinidazole became tinidazole resistant. Suspensions of nitroimidazole sensitive cultures of C pylori showed that three of 22 isolates had a nitroimidazole resistant subpopulation. In patients who healed and remained free of C pylori after treatment ulcers recurred less often than in patients who healed but retained C pylori (23% v 73% over 12 months, p < 0.001).

Original languageEnglish
Pages (from-to)207-210
Number of pages4
JournalJournal of Clinical Pathology
Volume41
Issue number2
DOIs
Publication statusPublished - 1 Jan 1988
Externally publishedYes

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