Susceptibility of clinical isolates of Campylobacter pylori to 24 antimicrobial and anti-ulcer agents.

Forty-nine isolates of Campylobacter pylori were tested for their susceptibility to twenty antibiotics and four anti-ulcer agents by an agar dilution technique. Penicillin and amoxycillin were the most active drugs (MIC90, 0.06 microgram/ml); erythromycin, cefazolin, minocycline, ciprofloxacin, ofloxacin and gentamicin were slightly less active (MIC90, less than or equal to 1 microgram/ml). Moderate activity was found for doxycyclin, rifampin, nitrofurantoin, norfloxacin, pefloxacin, enoxacin, paromomycin, metronidazole and tinidazole. All strains were resistant to trimethoprim (MIC greater than 512 micrograms/ml). Nalidixic acid (MIC90, greater than 256 micrograms/ml) and colistin (MIC90, greater than 64 micrograms/ml) had little to no activity. Of four anti-ulcer drugs, only bismuth subcitrate showed activity (MIC90, 64 micrograms/ml). Strains resistant to all 4-quinolones were found in patients who had previously received ofloxacin as part of a clinical trial aimed at eradication of C. pylori. These isolates remained susceptible to amoxycillin, tetracyclines and to other classes of antibiotics.