Abstract
The discovery of Helicobacter pylori has initiated a new approach to the treatment of gastritis and peptic ulcer disease. Effective therapy may need the inclusion of an antimicrobial agent aimed at eradicating the organism. However, several clinical studies have shown poor outcome of antibiotics in spite of good in vitro susceptibilities [1–7]. It has become clear that one can not extrapolate known pharmacokinetics and in vitro data of antibiotics and apply them directly to the treatment of H. pylori infection. The stomach represents a unique environment in the host. The presence of hydrochloric acid in the stomach necessitates the use of antibiotics that can retain activity at a pH much lower than what is seen in other parts of the body. They would also have to be secreted back into the stomach in order to achieve sustained tissue levels. In order to investigate which antibiotics might fulfill these criteria, an animal model for antibiotic concentrations in gastric mucosa has been developed [8].
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