ABSTRACT
The normal stomach is acid, and very few studies have been reported on the effect of antibiotics in acid media, especially on Helicobacter pylori. However, when an acid-reducing drug is given, eradication of H. pylori may be achieved with an antibiotic combination, compared to failure without the drug. To predict in vivo results, the susceptibility of H. pylori to antibiotics should be assessed not only in cell-free media, both liquid and solid, but also in association with cells, such as tissue culture, and preferably in animal models of infection. H. pylori in the fundus of the stomach will be less exposed to topical agents such as bismuth when these are swallowed, while the antrum would be far more exposed to such agents. All the antimicrobials attained gastric mucosal concentrations their minimum inhibitory concentrations for 90% of organisms' values at neutral pH for H. pylori, except in one patient who received erythromycin stearate.
