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