{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T14:09:51Z","timestamp":1793196591547,"version":"4.5.0"},"reference-count":41,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2012,9,25]],"date-time":"2012-09-25T00:00:00Z","timestamp":1348531200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2012,11]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Penicillins inhibit cell wall synthesis; therefore, <jats:italic><jats:styled-content style=\"fixed-case\">H<\/jats:styled-content>elicobacter pylori<\/jats:italic> must be dividing for this class of antibiotics to be effective in eradication therapy. Identifying growth responses to varying medium <jats:styled-content style=\"fixed-case\">pH<\/jats:styled-content> may allow design of more effective treatment regimens.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To determine the effects of acidity on bacterial growth and the bactericidal efficacy of ampicillin.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p><jats:italic>H. pylori<\/jats:italic> were incubated in dialysis chambers suspended in 1.5\u2010L of media at various <jats:styled-content style=\"fixed-case\">pH<\/jats:styled-content>s with 5\u00a0mM urea, with or without ampicillin, for 4, 8 or 16\u00a0h, thus mimicking unbuffered gastric juice. Changes in gene expression, viability and survival were determined.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At <jats:styled-content style=\"fixed-case\">pH<\/jats:styled-content> 3.0, but not at <jats:styled-content style=\"fixed-case\">pH<\/jats:styled-content> 4.5 or 7.4, there was decreased expression of ~400 genes, including many cell envelope biosynthesis, cell division and penicillin\u2010binding protein genes. Ampicillin was bactericidal at <jats:styled-content style=\"fixed-case\">pH<\/jats:styled-content> 4.5 and 7.4, but not at <jats:styled-content style=\"fixed-case\">pH<\/jats:styled-content> 3.0.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Ampicillin is bactericidal at <jats:styled-content style=\"fixed-case\">pH<\/jats:styled-content> 4.5 and 7.4, but not at <jats:styled-content style=\"fixed-case\">pH<\/jats:styled-content> 3.0, due to decreased expression of cell envelope and division genes with loss of cell division at <jats:styled-content style=\"fixed-case\">pH<\/jats:styled-content> 3.0. Therefore, at <jats:styled-content style=\"fixed-case\">pH<\/jats:styled-content> 3.0, the likely <jats:styled-content style=\"fixed-case\">pH<\/jats:styled-content> at the gastric surface, the bacteria are nondividing and persist with ampicillin treatment. A more effective inhibitor of acid secretion that maintains gastric <jats:styled-content style=\"fixed-case\">pH<\/jats:styled-content> near neutrality for 24\u00a0h\/day should enhance the efficacy of amoxicillin, improving triple therapy and likely even allowing dual amoxicillin\u2010based therapy for <jats:italic><jats:styled-content style=\"fixed-case\">H<\/jats:styled-content>. pylori<\/jats:italic> eradication.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.12059","type":"journal-article","created":{"date-parts":[[2012,9,26]],"date-time":"2012-09-26T08:31:32Z","timestamp":1348648292000},"page":"972-979","source":"Crossref","is-referenced-by-count":97,"title":["The effects of varying acidity on <i><scp>H<\/scp>elicobacter pylori<\/i> growth and the bactericidal efficacy of ampicillin"],"prefix":"10.1111","volume":"36","author":[{"given":"E. 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