Therapeutic Potential of Sitafloxacin as a New Drug Candidate for Eradication in Korea: An In Vitro Culture-Based Study.

BACKGROUND

Increased prevalence of antibiotic resistance to () infection worldwide has driven the search for a new therapeutic candidate. Recently, sitafloxacin, a novel 4-quinolone agent, has emerged as a new therapeutic option for eradication, in Japan. However, data on its efficacy for eradication in Korea are limited. Therefore, we aimed to investigate the therapeutic potential of sitafloxacin as a first-line treatment for patients with infection through gastric tissue culture-based studies.

MATERIALS AND METHODS

We prospectively enrolled treatment-naïve patients with infection who visited the Gil Medical Center between March 2015 and March 2018. After obtaining written informed consent from patients, a total of 121 strains were collected. We tested the susceptibility of these strains to sitafloxacin, and other antibiotics for Helicobacter eradication, including clarithromycin (CLR), metronidazole (MTZ), amoxicillin (AMX), tetracycline (TET), levofloxacin (LEV), and ciprofloxacin (CIP) using the agar dilution technique. The minimum inhibitory concentration (MIC) of these antibiotics against strains were determined.

RESULTS

None of the strains obtained were resistant to sitafloxacin (MIC > 1, = 0), while other conventional eradication drugs including CLR, MTZ, AMX, and TET showed 24.8% ( = 30), 30.6% ( = 37), 5.0% ( = 6), and 0.8% ( = 1) resistance, respectively. Compared to the resistance rates of other quinolones (LEV [36.4%, = 44] and CIP [37.2%, = 45]), sitafloxacin showed the best antibiotic performance against Helicobacter strains (0%, = 0). Furthermore, sitafloxacin also inhibited the growth of 14 strains (12.4%), which were resistant to both of clarithromycin, and metronidazole, and 27 strains (22.3%) with multidrug resistance.

CONCLUSIONS

Sitafloxacin might be a new promising candidate for Helicobacter eradication where antibiotic resistance for Helicobacter is an emerging medical burden, such as in Korea.