Aspirin- effects on therapy with Flagyl/Rifampin

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Gut. 2003 Apr;52(4):490-5.

Aspirin inhibits the growth of Helicobacter pylori and enhances its

susceptibility to antimicrobial agents.

Wang WH, Wong WM, Dailidiene D, Berg DE, Gu Q, Lai KC, Lam SK, Wong

BC.

Department of Gastroenterology, First Hospital, Peking University,

Beijing, China. bcywong@...

BACKGROUND AND AIM: The role of Helicobacter pylori and aspirin in

peptic ulcer formation and recurrence remains an important clinical

topic. The interaction between aspirin and H pylori in vitro is also

not clear. We investigated the effect of aspirin on the growth of H

pylori and on the susceptibility of H pylori to antimicrobials.

METHODS: Time killing studies of H pylori were performed with

different concentrations of aspirin and salicylate. Growth of

bacteria was assessed spectrophotometrically and by viable colony

count. The effects of aspirin on the efficiency of colony formation

and on metronidazole induced mutation to rifampicin resistance in H

pylori were determined. Minimal inhibitory concentrations (MICs) of

aspirin and metronidazole were tested by the standard agar dilution

method. MICs of amoxycillin and clarithromycin were determined by the

E test method. RESULTS: Aspirin and salicylate inhibited the growth

of H pylori in a dose dependent manner and bactericidal activity was

due to cell lysis. Aspirin 400 micro g/ml caused a 2 logs decrease in

colony forming units/ml at 48 hours, and suppressed the normal

ability of metronidazole to induce new mutations to rifampicin. The IC

(90) of aspirin was 512 micro g/ml. Increased susceptibility of

amoxycillin, clarithromycin, and metronidazole to H pylori was

observed at 1 mM (180 micro g/ml) aspirin.

CONCLUSIONS: Aspirin inhibited the growth of H pylori, suppressed the

mutagenic effect of metronidazole, and enhanced the susceptibility of

H pylori to antimicrobial agents. This mechanism is important in

future drug development for effective clearing and overcoming

resistance.

PMID: 12631656 [PubMed - indexed for MEDLINE