Helicobacter Forums

Hi

Asking for a second opinion before starting a course. ( this is for someone I know infected with H.pylori ). Although, I have been cured since 2016.


She has currently taken

1. Amox 1g , PPI 40mg, Clarithomycin ( failed)
2. Amox 1g , PPI 40mg, Clarithomycin (double dosage)- failed.

Currently being prescribed
- Amox 1g, Bismuth 120mg and Dexilant (PPI) 60mg.

Should she be taking another antibiotics?...ie: furandolizone or levofloxacin?...

Regards,
steve

This is one of my secret projects!

i'll be interested to know the outcome of this treatment.

The advantage of this treatment is that H. pylori cannot become resistant to Amox and Bismuth. So it's ok if the treatment failed. But i think to make this treatment work, she has to make sure that the Amox is 1g, three times a day; Bismuth is 240mg, 4 times a day.

Unfortunately, I don't want her to be a subject of an experiment to get the result.

The heavy doses of Bismuth is likely to cause alot of straining to her fragile stomach; ie: cramps and etc.
Would adding the levofloxacin twice a day along with the regime suggested hold a better successful eradication rate?.

Thanks again for the response.

Furazolidone is the antibiotic that we like to use in combination with bismuth and amoxicillin.

Can her doctor get access to Furazolidone?

otherwise, what about Metronidazole?

Hi helico expert,

thanks for your response.
Furazolidone is quite rare here. Metronidazole is easily available, but that being said, it is also broadly used in other ailments from simple flu/cold/inflammation in my country. ( Now the ministry to banning on the elaborate use of antibiotics used for these domestic ailments ).

Hence, h.pylori might be resistance to it.
btw, I am in South east asia, so the resistance recorded for this Metronidazole is quite high.
My previous quadruple regime ( bismuth, amox, metro /tetracycline + PPI ), did not manage to eradicate it.

I read there were studies on using them with combination ( amox, levo, PPI and bismuth) , yielding better result compare to triple, so I am not sure if you have statistics from your end regarding using this combinations.

Regards,
steve

How long should i take ranitidine before stool test

She can definitely try levofloxacin.

I think metronidazole is worth the trial as well. Metronidazole's resistance can be overcome when the other antibiotic is strong. You are a bit unfortunate that the Tetracycline and Metronidazole combination failed. I must say it's quite rare to have someone failing that combination.


cyprian zimunya
you can take ranitidine until the night before stool test.

So is it possible to use metronidazole again in another treatment regime after it failed in the last treatment.
Metronidazole,amox,bismuth,and esomeprazole 4omg does this work or i should replace metronidazole with another antibiotic ,if so which antibiotic can i add to replace metronidazole ...i cant manage to get access to furazolidone because it is not widely spread in my country

So far, it has been shown that metronidazole's resistance can be overcome when in combination with tetracycline.

Helico_expert wrote: ↑

Thu May 09, 2019 11:13 am

This is one of my secret projects!

i'll be interested to know the outcome of this treatment.

The advantage of this treatment is that H. pylori cannot become resistant to Amox and Bismuth. So it's ok if the treatment failed. But i think to make this treatment work, she has to make sure that the Amox is 1g, three times a day; Bismuth is 240mg, 4 times a day.

Hi helico_expert,
The patient took the similar prescription Amox, Bismuth, PPI , 4 times a day, within similar dosage.
UBT result still positive for h.pylori.
Hence, I don't think it is within the successful regime %.
No hard side-effects, except black stools due to bismuth.