Polysorbate 80 add-on therapy in the treatment of Helicobacter pylori infection: Polysorbate 80 and HP antibiotic resistance

Clin Nutr ESPEN. 2019 Dec:34:101-103. doi: 10.1016/j.clnesp.2019.08.005. Epub 2019 Aug 19.

Abstract

Polysorbate 80, a sorbitan derivate, is a surfactant used as an emulsifier in some foods in concentrations of up to 0.5%. It was recently shown in vitro that polysorbate 80 decreases the minimum bactericidal concentrations of clarithromycin and metronidazole and may also revert antibiotic resistance. We report the case of an adult man, suffering from symptomatic Helicobacter pylori (HP) infection resistant to two courses of treatment with PPI plus amoxicillin and clarithromycin, and PPI plus clarithromycin and metronidazole. He was treated with a further antibiotic approach consisting of two-week administration of clarithromycin, metronidazole, PPI and polysorbate 80 as an add on therapy. Eradication of infection was confirmed by 13C-urea breath test two and five months after completion of the treatment course. Complete regression of symptoms was also achieved. To our knowledge, this is the first case of HP infection eradicated with a combination therapy based on polysorbate 80 added to antibiotics.

Keywords: Antibiotic resistance; Helicobacter pylori; Polysorbate 80; Resistant HP infection; Tween 80.

Publication types

  • Case Reports

MeSH terms

  • Amoxicillin / therapeutic use
  • Anti-Bacterial Agents / therapeutic use
  • Clarithromycin / therapeutic use
  • Drug Combinations
  • Drug Resistance, Bacterial / drug effects*
  • Helicobacter Infections / drug therapy*
  • Helicobacter pylori / drug effects*
  • Humans
  • Male
  • Metronidazole / therapeutic use
  • Microbial Sensitivity Tests
  • Middle Aged
  • Polysorbates / administration & dosage
  • Polysorbates / therapeutic use*

Substances

  • Anti-Bacterial Agents
  • Drug Combinations
  • Polysorbates
  • Metronidazole
  • Amoxicillin
  • Clarithromycin