Tetracycline and Amoxicillin as Promising Antibiotics in First-Line Treatment of Helicobacter Pylori Infection

Helicobacter pylori (H. pylori) infection is associated with many gastroduodenal disorders. So far, few updated reports exist on the pattern of susceptibility to antibiotics that are mainly used in Iran. Our main purpose of this study was to investigate the resistance of H. pylori to tetracycline, amoxicillin, metronidazole, and clarithromycin in Iranian patients with dyspepsia. Due to the increasing resistance of H. pylori against the current first-choice antibiotics, alternative drugs including tetracycline may be the focus of attention by clinicians.

In this survey, after the bacterial culture of 200 gastric biopsy specimens obtained from consecutive patients, H. pylori strains were identified and confirmed using universal standard methods. Minimal inhibitory concentration (MIC) values of tetracycline were determined by E-test method.

Of 200 taken biopsy specimens, 73 (36%) samples were positive for H. pylori infection. Overall, the resistance to metronidazole was detected (46%), to amoxicillin (6%), to clarithromycin (16%), and to tetracycline (13%). In our examination, no significant association was found between the H. pylori antibiotic-resistant infections and age or sex. Our findings confirm the urgent need for susceptibility testing to find the best anti-H. pylori therapeutic regimen in our geographical region.

Our results support the higher importance of tetracycline and amoxicillin as alternatives and options in first-line therapy.