| Autor: |
Watanabe, Koichiro, Murakami, Kazunari, Sato, Ryugo, Kashimura, Koji, Miura, Masahiro, Ootsu, Satoshi, Miyajima, Hajime, Nasu, Masaru, Okimoto, Tadayoshi, Kodama, Masaaki, Fujioka, Toshio |
| Zdroj: |
Antimicrobial Agents and Chemotherapy; December 2004, Vol. 48 Issue: 12 p4582-4588, 7p |
| Abstrakt: |
ABSTRACTIt has been documented that sucralfate, a basic aluminum salt, enhances the efficacies of antibiotics against Helicobacter pylori, resulting in eradication rates comparable to those associated with the use of proton pump inhibitors. However, its mechanism of action remains unclear. The aim of the present study was to investigate sucralfate's ability to complement antibiotic treatment of H. pyloriinfection in vivo. Four weeks following induced H. pyloriinfection, clarithromycin (CAM) and amoxicillin (AMPC) were administered orally to C57BL/6 mice for 5 days, both with and without sucralfate or lansoprazole. When sucralfate was concurrently given with CAM and AMPC at the maximum noninhibitory doses for the treatment of H. pyloriinfection, the bacterial clearance rates were comparable to those achieved by treatment with lansoprazole plus those antibiotics. The results of pharmacokinetic studies showed that lansoprazole delayed gastric clearance and accelerated the absorption of CAM, whereas sucralfate suppressed both gastric clearance and absorption. AMPC was undetectable in all samples. Scanning electron microscopy with a microscope to which a energy dispersive spectrometer was attached revealed that aluminum-containing aggregated substances coated the mucosa surrounding H. pyloriin mice receiving sucralfate plus antibiotics, whereas the gastric surface and pits where H. pylorihad attached were clearly visible in mice receiving lansoprazole plus antibiotics. The addition of sucralfate to the antibiotic suspension resulted in a more viscous mixture that bound to the H. pylori-infected mucosa and that inhibited the loss of CAM bioavailability in the acidic environment. Sucralfate delays gastric clearance of CAM and physically captures H. pylorithrough the creation of an adherent mucus, which leads to bacterial clearance. |
| Databáze: |
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