Next Generation 5-Nitroimidazole Compounds Show Potential as New Therapeutic Alternatives to Metronidazole in Helicobacter pylori Infection

5-Nitroimidazole (5-NI) compounds are used to treat a variety of bacterial and parasitic infections. Metronidazole (Mz), a 5-NI drug, is a safe and affordable drug that has been used for nearly half a century to treat infections caused by intestinal pathogens. When combined with other medications Mz has successfully been used to treat H. pylori infections. H. pylori is a microaerophilic bacteria that causes a range of gastrointestinal diseases. While Mz is active against H. pylori, the treatment failure rate of Mz centered therapy is increasing (Peter J. Jenks 2002). Others have taken advantage of the ability to synthesize structurally diverse 5-NI compounds and have found that some of the newly derived compounds are highly potent compared to Mz (Jacqueline A. Upcroft 2006). We asked if 5-Ni compounds, apart from Mz, could reduce the growth rate of H. pylori and potentially function as new antibiotics. We show that 5-NI compounds are active against multiple strains of H. pylori. Also, we found four compounds that are able to overcome Mz-resistance. Finally, we propose a new method for gaining a better understating of Mz resistance mechanisms using a strain's compound activity profile coupled with phylogenetic tools