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

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Author(s): Shahram Agah | Seyed-Mohammad Fereshtehnejad | Azadeh Yousefnejad | Farideh Siavashi

Journal: Iranian Journal of Pharmacology and Therapeutics
ISSN 1735-2657

Volume: 7;
Issue: 1;
Start page: 57;
Date: 2008;
Original page

Keywords: Helicobacter pylori | Metronidazole resistance | Ketoconazole | Fluconazole

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 40mg/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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