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Antimicrobial Agents and Chemotherapy, December 2003, p. 3780-3783, Vol. 47, No. 12
0066-4804/03/$08.00+0     DOI: 10.1128/AAC.47.12.3780-3783.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.

Nitazoxanide in Treatment of Helicobacter pylori: a Clinical and In Vitro Study

Yvonne Guttner,1 Helen M. Windsor,2 Charlie H. Viiala,1 Leon Dusci,3 and Barry J. Marshall1,2*

Department of Gastroenterology, Sir Charles Gairdner Hospital,1 NHMRC Helicobacter pylori Research Laboratory, Department of Microbiology, University of Western Australia,2 Department of Pharmacology and Toxicology, PathCentre, Perth, Australia3

Received 3 April 2003/ Returned for modification 30 June 2003/ Accepted 8 September 2003

Nitazoxanide (NTZ) is an antibiotic with microbiological characteristics similar to those of metronidazole but without an apparent problem of resistance. The aim of this study was the prospective evaluation of NTZ given as a single agent in the treatment of Helicobacter pylori infection. Twenty culture-positive patients with dyspepsia who had previously failed at least one course of H. pylori eradication therapy were enrolled. Subjects received 1 g of NTZ twice daily for 10 days. The safety and tolerability of the drug were assessed by physical examination, monitoring of adverse events, and clinical laboratory evaluation. Urea breath tests (UBTs) were performed 6 weeks posttreatment. H. pylori was isolated from UBT-positive patients by the string test or endoscopy with biopsy, and the MICs for these isolates were compared to those for isolates obtained pretherapy. The levels of tizoxanide, the active deacylated derivative of NTZ, were measured in blood, saliva, and tissue from two patients during treatment. The UBT results were positive for all 20 patients after completion of NTZ therapy. The MIC results demonstrated that the NTZ susceptibilities of none of the strains isolated from the patients posttherapy had changed significantly. No major adverse reactions were observed, but frequent minor side effects were observed. In conclusion, NTZ did not eradicate H. pylori when it was given as a single agent.

* Corresponding author. Mailing address: NHMRC Helicobacter pylori Research Laboratory, Department of Microbiology, University of Western Australia, QEII Medical Centre, Nedlands 6009, Australia. Phone: 61-8-9346-4815. Fax: 61-8-9346-4816. E-mail: admin{at}hpylori.com.au.

Antimicrobial Agents and Chemotherapy, December 2003, p. 3780-3783, Vol. 47, No. 12
0066-4804/03/$08.00+0     DOI: 10.1128/AAC.47.12.3780-3783.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.



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