RESUMEN
The problematic Helicobacter pylori infection is to be better treated by some integrated formulations based on the synergistic actions among antibiotics and some natural products. The study was performed using H. pylori isolated from the three most common reservoirs, namely: flies, human stomach and human stool. The extra cellular protein profiles of different members of H. pylori isolated from flies, gastric biopsies, and stool were found to be heterogeneous. Six anti-H. pylori antibiotics were used in single, double and triple combinations with curcumin, and with the extra-cellular products of Lactobacillus acidophilus to evaluate the synergistic action. Extra-cellular protein profiles of different H. pylori were found to be noticeably influenced by MIC50 of the used antibiotics and curcumin. The order of resistance of H. pylori isolates to different treatments was as follows; stool > gastric > flies. In case of gastric H. pylori, the percent synergy for the double treatment was 28.63% for curcumin, 70.35% for L. acidophilus and 81% for the triple treatment. Antimicrobial activity of curcumin together with L. acidophilus were also synergistic. Urease activity of different H. pylori was studied in acidic, neutral and alkaline conditions in the presence of curcumin, L. acidophilus and the mixture of them and found to be decreased in all treatments relative to the control. Curcumin was more anti-urease in case of gastric H. pylori while L. acidophilus more effective in case of fecal H. pylori. Accordingly, antibiotic, curcumin, and L. acidophilus triple therapy can be recommended for the eradication of H. pylori infection after concise animal and human in vivo trials and evaluations