rifampin and Stomach-Ulcer

P-glycoprotein (P-gp) is an Adenosine triphosphate (ATP) dependent drug-efflux pump which is located abundantly in the stomach and protects the gut mucosa from xenobiotic.. The purpose of this study was to investigate the influence of P-gp modulation on the efficacy of treatment regimen.. P-gp modulation in rats was performed by using P-gp inducer (150 mg/kg rifampicin) and P-gp inhibitor (10 mg/kg cyclosporine A) for 14 days prior to be infected with Helicobacter pylori (H. pylori). The rats were further divided into groups, which were normal control, vehicle control, antibiotics and omeprazole, antibiotics only and omeprazole only for another 2 weeks of treatment. The ulcer formation and P-gp expression were determined by using macroscopic evaluation and western blot analysis, respectively.. The highest P-gp expression was shown in the induced P-gp rats (2.00 ± 0.68) while the lowest P-gp expression was shown in the inhibited P-gp rats (0.45 ± 0.36) compared to the normal P-gp rats. In all groups, the rats which were infected with H. pylori, had a significant increase (p < 0.05) in P-gp expression level and a more severe ulcer formation compared to the healthy rats. The ulcer developed at different levels in the rats with inhibited, induced, or normal P-gp expression. After receiving the standard therapy for H. pylori, it was observed that the healing rate for ulcer was increased to 91% (rats with inhibited P-gp expression), 82% (rats with induced P-gp expression) and 75% in rats with normal P-gp. The use of rifampicin to induce P-gp level was also shown to be effective in eradicating the H. pylori infection.. The synergism in the standard therapy by using two antibiotics (clarithromycin and amoxicillin) and proton pump inhibitor (omeprazole) have shown to effectively eradicate the H. pylori infection. Thus, P-gp expression influenced the effectiveness of the treatment.

Topics: Amoxicillin; Animals; Anti-Bacterial Agents; Anti-Ulcer Agents; ATP Binding Cassette Transporter, Subfamily B, Member 1; Clarithromycin; Cyclosporine; Drug Therapy, Combination; Helicobacter Infections; Helicobacter pylori; Male; Omeprazole; Proton Pump Inhibitors; Rats, Sprague-Dawley; Rifampin; Stomach Ulcer

Gastrointestinal disturbances like anorexia, nausea, vomiting, abdominal discomfort and diarrhoea are known adverse effects of rifampicin. We report an upper gastrointestinal bleeding due to haemorrhagic gastric erosions after ingestion of rifampicin for pulmonary tuberculosis. The cause and effect relationship between development of haemorrhagic gastric erosions and rifampicin administration was confirmed by rechallenge with rifampicin. To our knowledge no such adverse effect of rifampicin has been reported previously.

Topics: Child; Gastrointestinal Hemorrhage; Humans; Male; Rifampin; Stomach Ulcer; Tuberculosis, Pulmonary