Marshall and Warren discovered Helicobacter pylori, which is now recognized as a major gastric pathogen with worldwide distribution. H. pylori is a prevalent human-specific pathogen and a causative agent in chronic active gastritis, duodenal ulcers, and gastric adenocarcinoma.1-3) Although the microorganism is susceptible to many antimicrobial agents in vitro, clinical trials with a single antimicrobial agent have resulted in a low eradication rate of H. pylori. 3,4) This is because of the low concentration of the antibiotic reaching the bacteria under the mucosa; instability of the drug in the low pH of gastric fluid, and the short residence time of the antibiotic in the stomach. 5) Therefore, eradicating H. pylori is a prerequisite for curing a gastric or peptic ulcer and preventing a recurrence.3) Triple therapy consisting of combined use of antibiotics, such as amoxicillin, clarithromycin/metronidazole, and a proton pump inhibitor gives a high eradication rate, and is now frequently used for clinical treatment of H. pylori associated gastroduodenal disease. However, eradication is not always successful and harmful side effects, cost of therapy, and the lack of willingness to take many different drug products are the major drawbacks of the therapy. 5,6) Other than the multi-antibiotic therapy, other strategies that can completely eradicate H. pylori from the stomach have been examined. One way to improve the efficacy in eradicating the infection is to deliver the antibiotic locally in the stomach 5,7) by increasing residence time of antibiotics at infected site. Another way is to improve the stability of antibiotics in gastric environment. The antibiotics with better stability and longer residence time will allow more of the antibiotic to penetrate through the gastric mucus layer to act effectively on H. pylori. Gastroretentive drug delivery systems like floating and bioadhesive system would improve the therapeutic effect of antimicrobial drugs.8) Research into gastroretentive drug delivery systems has resulted in the development of several approaches including the use of tabletsin-capsule, 9) floating systems 10,11) in situ gelling systems, 12,13) mucoadhesive tablet, pH-sensitive excipient composition mucoadhesive microspheres 14,15) etc., which were able to reside in the gastrointestinal tract for an extended period of time for a more effective H. pylori eradication.Mucoadhesive drug carriers may prolong the residence time in the gastrointestinal tract (GI) tract because they can adhere to the mucus surface, resulting in an effective localized drug concentration.10,15) Among several mucoadhesive polymers, Carbopol usually has strong mucoadhesive properties and is known to be biocompatible and nontoxic. Multiple unit gastroretentive dosage forms, like floating microspheres or microcapsules, can be distributed widely throughout the GI tract, providing the possibility of achieving a longer lasting and more reliable release of drugs. 16,17) Clarithromycin is a macrolide, orally absorbed, broad-spectrum antibio...
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