Antimicrobial Activity of Ketoconazole and Fluconazole against Metronidazole Resistance Strains of Helicobacter pylori: an In Vitro Study

Authors

  • Azadeh Yousefnejad
  • Farideh Siavashi
  • Seyed-Mohammad Fereshtehnejad
  • Shahram Agah
Abstract:

Resistance to drug such as metronidazole is one the commonest causes of treatment failure while eradicating Helicobacter pylori . Considering the safety of ketoconazole and fluconazole and their inhibitory activity on biosynthesis of fatty acids from cholesterol in cell membrane of H.pylori , the idea of their efficacy against H.pylori is raising . The aim of this study is to evaluate susceptibilities of metronidazole-resistant strains of H.pylori against two antifungal drugs, ketoconazole and fluconazole. In this prospective cross-sectional study, 35 isolates of H.pylori from patients with digestive disorders were recruited. Plates were incubated microaerobically. Resistance to metronidazole, minimum inhibitory concentrations (MIC) of ketoconazole and fluconazole for H.pylori isolates were determined by two methods: disc diffusion and agar dilution. Disc diffusion method indicated that metronidazole resistance was seen in 11 strains out of 35. Ketoconazole and fluconazole MICs were 8 and 40 mg/lit , respectively, which was confirmed by agar dilution method. Ketoconazole and fluconazole showed an excellent in vitro activity against the H.pylori isolates. However, in vivo activity of these drugs should be evaluated in controlled clinical trials.

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Journal title

volume 7  issue 1

pages  57- 0

publication date 2008-10

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