Message Number: YG1459 | New FHL Archives Search
From: Bruce Williams, DVM
Date: 2001-03-19 22:39:00 UTC
Subject: Re: Revolution And Pepto

--- In Ferret-Health-list@y..., Carla Christman <sebestianpup@y...>
> The second thing I've been dying to ask is for Bruce.
> Isn't there a reason why Bismuth is used in the
> treatment of helicobacter? Rather than simply coat the
> stomach, I understood it was actually making the
> bacteria more susceptible to the antibiotics.

The true mechanism of action of bismuth's antibacterial action,
especially Helicobacter is as yet unknown (perhaps our list
pharmacist is able to help here). Experiments have shown
concentrations of bismuth subjacent to the bacterial cell wall. It
has indeed been thought that the use of bismuth has relieved some
antibiotic resistance in strains of Helicobacter.

> carafate do the same? Or did they find that the
> bismuth was not important?

In humans with Helicobacter infection, bismuth continues to be a
cornerstone of therapy. Bismuth subsalicylate (Pepto) and not
ranitidine bismuth citrate (Tritec) a combination H2 blocker and mild
antibiotic are commonly used both in primary therapy and rescue
therapies. Also in humans, tetracycline often replaces amoxicillin
in some triple therapy regimes.

There is no doubt that bismuth is of use in treating Helicobacter
both in humans and ferrets. However, the problems associated with
giving Pepto to ferrets, and lack of a good alternative has often
caused many vets to pursue alternate therapy.

With kindest regards,

Bruce H. Williams, DVM, DACVP
Join the Ferret Health List at

There was an article in
> Compendium that I saved on helicobacter - March 1997,
> vol 19, no. 3, pages 267-279.
> Carla Christman, DVM
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