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Question re: how to to take Quadruple therapy

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sparkling2006
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Question re: how to to take Quadruple therapy

Post by sparkling2006 » Wed Nov 30, 2016 1:17 pm

Hi all and Helico Experts,

After failed two rounds of triple therapy to eradicate HP, I am now prescribed with a quadruple therapy as these :

De-nol tab 4 times daily
Flagyl 4 times daily
Doxycycline 2 times daily
Omeprazole 2 times daily

How should I take these pills to maximize the drug efficacy? The specialist just mentioned to me I could take these all together in the 1st and last dose of the day without the need to have intervals in between taking each of them. Is this right ? I have already taken them together without intervals on my first day today - will this impact the efficacy of eradication if taking these together is not the right way ?

Thanks for any advice.

sparkling2006
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Re: Question re: how to to take Quadruple therapy

Post by sparkling2006 » Wed Nov 30, 2016 1:24 pm

If taking these drugs all together,would any one of the drugs inhibit the other drugs' efficacy ? If yes, what would be the best way to schedule the taking ?

Helico_expert
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Re: Question re: how to to take Quadruple therapy

Post by Helico_expert » Thu Dec 01, 2016 12:52 am

actually, the idea is to space out the antibiotics. For those that you need to take 2 times a day, give yourself 12 hours gap. For those that you need to take 4 times a day, spread it as evenly as possible in 24 hours (of course, not during your sleep time at night). It doesnt really matter if it is before or after meal.

sparkling2006
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Re: Question re: how to to take Quadruple therapy

Post by sparkling2006 » Thu Dec 01, 2016 1:30 am

Thanks for the reply.

Can De-nol tab be taken with food and Flagyl, PPI and Doxycycline ? I read from the Astellas website that it should be taken alone 30 mins before the 3 main meals and last dose at bedtime. Also it mentions De-nol tab may interfere with Tetracycline hence should space out the drugs for 2 hours ?

For the PPI do I need to take it before meals and alone ? I am worried if the drugs would interfere the other one if not spacing out the time ?

I asked the physician about this and she says it doesn't matter but I am still doubting.

Helico_expert
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Re: Question re: how to to take Quadruple therapy

Post by Helico_expert » Fri Dec 02, 2016 6:13 am

we tried giving before and after meal to patients. There is insignificant difference in terms of cure rate.

I am not aware of any drug drug interaction among these antibiotics. However, Bismuth and Tetracycline combination has been widely prescribed. Should there be any interaction, it would have been reported.

If you are interested, you can check out Pylera. It's a quadruple therapy with both bismuth and tetracycline combined.

sparkling2006
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Re: Question re: how to to take Quadruple therapy

Post by sparkling2006 » Fri Dec 02, 2016 1:56 pm

Thanks for replying. I really hope this therapy will work!

I also have doubts re the c13 urea breath test. The last one I took shows HP+ve with the count of 52+ . Does this indicate the amount of bacteria? If yes is this count considered a high amount? Could it be the higher the count the more difficult to eradicate the bug?

When I did the test I actually couldn't blow up the 2nd bag “fully“ in one shot. The nurse told me I had to get it bloated fully. So I inhaled and exhaled again to get it done. Would this cause the results false negative or distort the count ?

Another incidence is after I finished blowing up the 1st bag, the whole straw was slipped into the bag by accident. The nurse had to slightly shake the bag to back it out. Would this impact the results as well ?

Sorry for asking so many questions but I am really getting so freaked out to get this bug eradicated. :|

Helico_expert
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Re: Question re: how to to take Quadruple therapy

Post by Helico_expert » Fri Dec 02, 2016 3:45 pm

the reading of the urea breath test does correlate to the amount of H. pylori in your stomach. The higher the reading, the more H. pylori. However, the amount of H. pylori doesnt correlate to disease severity nor treatment failure rate. We have seen asymptomatic patients with very high reading and we have seen border line reading patients with ulcers.

The way the breath test is carried out or the breath was collected will affect the breath test outcome. Nevertheless, a reading of 52 is high enough to be trustable. In your case, you should worry if it is a negative. But you got a positive reading. So, please go ahead with the treatment.

sparkling2006
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Re: Question re: how to to take Quadruple therapy

Post by sparkling2006 » Sat Dec 03, 2016 2:04 am

Borderline reading would be a count close to the cut-off value ? Many thanks for answering!

Helico_expert
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Re: Question re: how to to take Quadruple therapy

Post by Helico_expert » Sat Dec 03, 2016 4:12 pm

yea, borderline reading means result very close to the cut off.

no worries.

sparkling2006
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Re: Question re: how to to take Quadruple therapy

Post by sparkling2006 » Tue Dec 06, 2016 8:58 am

Many thanks for replying. I have a few more questions after starting the treatment for 6 days now.

1st : Is Bismuth considered an antibiotic in the Quadruple therapy I am taking ? My specialist told me he would prescribe me 3 antibiotics : Flagyl, Doxy and Bismuth. But from the Google world Bismuth is mainly composed of salts ? Curious to know how it can kill the HP bug if it is not an antibiotic ?

2nd : I read that many people mention it's easy to have under the same roof get infected if one person is found +ve. I am currently living with my parents. We are very well aware of personal hygiene. We do not share food and wash our hands always esp after using the bathroom, etc. Will the bacteria be transmitted easily during conversations over food when having meals ? I also read that if a person has good immunity will not be infected easily even they are exposed to it ? I think I am getting a bit paranoid sometimes and worrying about everything I do would get them infected.

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