Abstract
Aim:
To investigate the distribution of amoxicillin in the gastric juice and gastric mucosa of rats and to investigate the effects of proton pump inhibitor rabeprazole on amoxicillin concentrations in various compartments.
Methods:
One hundred and sixty anesthetized rats were divided into five groups, and given intravenously different doses of amoxicillin or amoxicillin and rabeprazole. The pH value and volume of gastric juice was aspirated were measured and separated gastric mucosa was homogenized. The concentrations of amoxicillin in the plasma, gastric juice and gastric mucosa were measured by high performance liquid chromatography (HPLC).
Results:
The maximum concentrations of amoxicillin in gastric juice and gastric mucosa were significantly lower than those in plasma (P<0.001). Concentrations in the glandular stomach mucosa were higher than those in the forestomach mucosa. Rabeprazole did not significantly change the pharmacokinetic parameters of amoxicillin in the plasma and did not alter gastric antibiotic clearance or the gastric transfer fraction of amoxicillin in gastric juice. However, rabeprazole did increase the amoxicillin concentration and pH value in gastric juice and reduced the volume of the gastric juice.
Conclusion:
Amoxicillin could penetrate the gastric mucosa and achieve therapeutic concentrations at the target site after transfer from the blood to the stomach. Rabeprazole increased the amoxicillin concentration in gastric juice by decreasing the gastric juice volume but did not affect its concentration in blood or gastric mucosa.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
References
Konturek JW . Discovery by Jaworski of Helicobacter pylori and its pathogenetic role in peptic ulcer, gastritis and gastric cancer. J Physiol Pharmacol 2003; 54: 23–41.
Megraud F, Lehours P . Helicobacter pylori detection and antimicrobial susceptibility testing. Clin Microbiol Rev 2007; 20: 280–322.
Malfertheiner P, Mégraud F, O'Morain C, Bazzoli F, El-Omar E, Graham D, et al. Current concepts in the management of Helicobacter pylori infection: the Maastricht III Consensus Report. Gut 2007; 56: 772–81.
Yoshiyama H, Nakazawa T . Unique mechanism of Helicobacter pylori for colonizing the gastric mucus. Microbes Infect 2000; 2: 55–60.
Henriksnäs J, Phillipson M, Storm M, Engstrand L, Soleimani M, Holm L . Impaired mucus-bicarbonate barrier in Helicobacter pylori-infected mice. Am J Physiol Gastrointest Liver Physiol 2006; 291: 396–403.
Van Zanten SJ, Kolesnikow T, Leung V, O'Rourke JL, Lee A . Gastric transitional zones, areas where Helicobacter treatment fails: results of a treatment trial using the Sydney strain mouse model. Antimicrob Agents Chemother 2003; 7: 2249–55.
Nakamura M, Spiller RC, Barrett DA, Wibawa JI, Kumagai N, Tsuchimoto K, et al. Gastric juice, gastric tissue and blood antibiotic concentrations following omeprazole, amoxicillin and clarithromycin triple therapy. Helicobacter 2003; 8: 294–9.
Pedrazzoli J Jr, Calafatti SA, Ortiz RA, Dias FE, Deguer M, Mendes FD, et al. Transfer of clarithromycin to gastric juice is enhanced by omeprazole in Helicobacter pylori-infected individuals. Scand J Gastroenterol 2001; 36: 1248–53.
Mégraud F . H pylori antibiotic resistance: prevalence, importance, and advances in testing. Gut 2004; 53: 1374–84.
Pajares GarcÃa JM, Pajares-Villarroya R, Gisbert JP . Helicobacter pylori infection: antibiotic resistance. Rev Esp Enferm Dig 2007; 99: 63–70.
Gerrits MM, van Vliet AH, Kuipers EJ, Kusters JG . Helicobacter pylori and antimicrobial resistance: molecular mechanisms and clinical implications. Lancet Infect Dis 2006; 6: 699–709.
Sakai T, Aoyama N, Kita T, Sakaeda T, Nishiguchi K, Nishitora Y, et al. CYP2C19 genotype and pharmacokinetics of three proton pump inhibitors in healthy subjects. Pharm Res 2001; 18: 721–7.
Besancon M, Simon A, Sachs G, Shin JM . Sites of reaction of the gastric H, K-ATPase with extracytoplasmic thiol reagents. J Biol Chem 1997; 272: 22438–46.
Goddard AF, Erah PO, Barrett DA, Shaw PN, Spiller RC . The effect of protein binding and lipophilicity of penicillins on their in-vitro flux across gastric mucosa. J Antimicrob Chemother 1998; 41: 231–6.
Hammer TA, Sandvik AK, Waldum HL . Potentiating hypergastrinemic effect by the peroxisome proliferator ciprofibrate and omeprazole in the rat. Scand J Gastroenterol 1998; 33: 595–9.
Du X, Li C, Sun HK, Nightingale CH, Nicolau DP . A sensitive assay of amoxicillin in mouse plasma and broncho-alveolar lavage fluid by liquid–liquid extraction and reversed-phase HPLC. J Pharm Biomed Anal 2005; 39: 648–52.
Pires de Abreu LR, Ortiz RM, de Castro SC, Pedrazzoli J Jr . HPLC determination of amoxicillin comparative bioavailability in healthy volunteers after a single dose administration. J Pharm Pharm Sci 2003; 6: 223–30.
Sherwood PV, Wibawa JI, Atherton JC, Jordan N, Jenkins D, Barrett DA, et al. Impact of acid secretion, gastritis, and mucus thickness on gastric transfer of antibiotics in rats. Gut 2002; 51: 490–5.
Goddard AF, Jessa MJ, Barrett DA, Shaw PN, Idström JP, Cederberg C, et al. Effect of omeprazole on the distribution of metronidazole, amoxicillin, and clarithromycin in human gastric juice. Gastroenterology 1996; 111: 358–67.
Graham DY . Therapy of Helicobacter pylori: current status and issues. Gastroenterology 2000; 118: S2–8.
Rokkas T, Sechopoulos P, Robotis I, Margantinis G, Pistiolas D . Cumulative H pylori eradication rates in clinical practice by adopting first and second-line regimens proposed by the Maastricht III consensus and a third-line empirical regimen. Am J Gastroenterol 2009; 104: 21–5.
Atherton JC, Cockayne A, Balsitis M, Kirk GE, Hawkey CJ, Spiller RC . Detection of the intragastric sites at which Helicobacter pylori evades treatment with amoxycillin and cimetidine. Gut 1995; 36: 670–4.
Ortiz RA, Calafatti SA, Corazzi A, Souza JM, Deguer M, De Souza CA, et al. Amoxicillin and ampicillin are not transferred to gastric juice irrespective of Helicobacter pylori status or acid blockade by omeprazole. Aliment Pharmacol Ther 2002; 16: 1163–70.
Endo H, Yoshida H, Kohno Y, Suga T . Effects of clarithromycin and amoxicillin on gastric emptying in rats. Antimicrob Agents Chemother 2002; 46: 3331–3.
Endo H, Yoshida H, Ohmi N, Ohta K, Higuchi S . Localization of [14C]amoxicillin in rat gastric tissue when administered with lansoprazole and clarithromycin. J Antimicrob Chemother. 2001; 48: 923–6.
Matysiak-Budnik T, Heyman M, Candalh C, Lethuaire D, Mégraud F . In vitro transfer of clarithromycin and amoxicillin across the epithelial barrier: effect of Helicobacter pylori. J Antimicrob Chemother 2002; 50: 865–72.
Lozniewski A, de Korwin JD, Muhale F, Jehl F . Gastric diffusion of antibiotics used against H pylori. Int J Antimicrob Agents 1997; 9: 181–93.
Lozniewski A, Duprez A, Renault C, Muhale F, Conroy MC, Weber M, et al. Gastric penetration of amoxicillin in a human Helicobacter pylori-infected xenograft model. Antimicrob Agents Chemother 1999; 43: 1909–13.
Van Zanten SJ, Goldie J, Hollingsworth J, Silletti C, Richardson H, Hunt RH . Secretion of intravenously administered antibiotics in gastric juice: implications for management of Helicobacter pylori. J Clin Pathol 1992; 45: 225–7.
Kurasawa T, Chikaraishi Y, Naito A, Toyoda Y, Notsu Y . Effect of humulus lupulus on gastric secretion in a rat pylorus-ligated model. Biol Pharm Bull 2005; 28: 353–7.
Lang L, GarcÃa F . Comparison of E-test and disk diffusion assay to evaluate resistance of Helicobacter pylori isolates to amoxicillin, clarithromycin, metronidazole and tetracycline in Costa Rica. Int J Antimicrob Agents 2004; 24: 572–7.
Wolle K, Leodolter A, Malfertheiner P, König W . Antibiotic susceptibility of Helicobacter pylori in Germany: stable primary resistance from 1995 to 2000. J Med Microbiol 2002; 51: 705–9.
Adamek RJ, Wegener M, Opferkuch W, Rühl GH . Successful Helicobacter pylori eradication: a systemic effect of antibiotics. Am J Gastroenterol 1993; 88: 792–3.
Adamek RJ, Wegener M, Labenz J, Freitag M, Opferkuch W, Rühl GH . Medium-term results of oral and intravenous omeprazole/amoxicillin Helicobacter pylori eradication therapy. Am J Gastroenterol 1994; 89: 39–42.
Murakami K, Okimoto T, Kodama M, Sato R, Watanabe K, Fujioka T . Evaluation of three different proton pump inhibitors with amoxicillin and metronidazole in retreatment for Helicobacter pylori infection. J Clin Gastroenterol 2008; 42: 139–42.
Kuwayama H, Asaka M, Sugiyama T, Fukuda Y, Aoyama N, Hirai Y, et al. Rabeprazole-based eradication therapy for Helicobacter pylori: a large-scale study in Japan. Aliment Pharmacol Ther 2007; 25: 1105–13.
Sharara AI, Chaar HF, Aoun E, Abdul-Baki H, Araj GF, Kanj SS . Efficacy and safety of rabeprazole, amoxicillin, and gatifloxacin after treatment failure of initial Helicobacter pylori eradication. Helicobacter 2006; 11: 231–6.
Kita T, Tanigawara Y, Aoyama N, Hohda T, Saijoh Y, Komada F, et al. CYP2C19 genotype related effect of omeprazole on intragastric pH and antimicrobial stability. Pharm Res 2001; 18: 615–21.
Acknowledgements
This work was supported by the Natural Sciences Research Foundation from the Department of Education of Anhui Province, China (No KJ 2008B064).
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Zheng, Hl., Hu, Ym., Bao, Jj. et al. Transfer and distribution of amoxicillin in the rat gastric mucosa and gastric juice and the effects of rabeprazole. Acta Pharmacol Sin 31, 501–508 (2010). https://doi.org/10.1038/aps.2009.191
Received:
Accepted:
Published:
Issue date:
DOI: https://doi.org/10.1038/aps.2009.191