Cannot take fluoroquinolones or macrolides

The most popular treatments consist of two antibiotics (one of which is usually clarithromycin) plus a strong acid blocker such as omeprazole (PriLosec, Nexium, Somac, Zoton, etc.). Treatment is for 7-10 days. Cure rate is about 85%

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CanGal
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Cannot take fluoroquinolones or macrolides

Post by CanGal » Mon May 23, 2016 7:59 pm

Hello, I have recently been diagnosed with H Pylori (breath test) and have been trying unsuccessfully to treat it with natural alternatives due to severe side effects/allergies to flouroquinolones (Cipro) and macrolides (Clarithromycin). I have a long history of taking ABX for chronic strep infections and UTI's and I think my H Pylori actually grew resistance due to frequent use of ABX.

I have reviewed the treatment combination charts (PARC, etc) that have been previously posted on the boards by helico_expert and am not sure what first line combination therapy would be best for me. I also read Amox and Tetracycline should not be used together as first line therapy.

Because of my history of antibiotic use, it would be my preference to use only 2 ABX in combination with Bismuth - as well as be on the most successful combination so I only have to do this once.

I do not believe I've ever been on Rifabutin or Furazolidone, so not sure which of these would work better in quadruple treatment for first line therapy.

Also should therapy be concomitant or consecutive?

Any help is appreciated, thanks!

Helico_expert
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Re: Cannot take fluoroquinolones or macrolides

Post by Helico_expert » Tue May 24, 2016 1:13 am

concomitant is stronger than sequential.

14 days is stronger than 10 days treatment.

double dose PPI increase cure rate.

Rifabutin has less side effect than Farazolidone.

Amoxicillin and bismuth can be used multiple times without giving resistance.

can your specialist culture the bacteria and perform an antibiotic sensitivity test?

CanGal
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Re: Cannot take fluoroquinolones or macrolides

Post by CanGal » Tue May 24, 2016 2:13 am

Helico_expert wrote:
can your specialist culture the bacteria and perform an antibiotic sensitivity test?
Thanks so much for your reply. I asked at my last appointment but was told I couldn't be referred for an endoscopy until 1st line therapy fails (and then there's a 2-4 month waiting list for the procedure). My GP is pretty good - she will follow my lead with most things and supports my efforts to avoid unnecessary ABX. Taking that into consideration, I may ask her for the following:

PPI (double dose)
Amoxicillin
Rifabutin
Bismuth

I'm in Canada and looked up Bismuth/DeNol in my research earlier today and it sounds like it might not be readily available here. Would over the counter Pepto Bismol suffice? I see each tablet contains 262mg of bismuth subsalicylate AND 350mg of calcium carbonate. I'm trying to do as much research as possible to increase my chances of success and avoid more ABX.

I may bring her some of the info from these forums and see if it would at all help me get triaged for a sensitivity test...?

Helico_expert
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Re: Cannot take fluoroquinolones or macrolides

Post by Helico_expert » Tue May 24, 2016 2:24 pm

Yup. That's a good idea. You can supplement with pepto bismol.

CanGal
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Re: Cannot take fluoroquinolones or macrolides

Post by CanGal » Tue May 24, 2016 10:36 pm

Great, thank you. Fingers crossed!

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