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RUT: positive or negative?

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Sajal
Posts: 48
Joined: Tue Mar 05, 2019 5:54 pm

Re: RUT: positive or negative?

Post by Sajal » Wed Aug 28, 2019 3:43 am

I have been meaning to ask whether I should go for PBMT therapy despite the fact that here in India metronidazole resistance is quite high ( above 50 percent). Infact metronidazole is considered the least sensitive antibiotic for h pylori.

I have read that tetracycline and bismuth can overcome metronidazole resistance. So should I give PBMT a try or consider other antibiotics therapies like PBAT or PBAF?

I would like to go for the therapy with higher prospect of eradication.

P.S.– have done unsuccessful clarithro- amox based triple therapy.

Helico_expert
Site Admin
Posts: 3470
Joined: Wed Mar 02, 2011 7:20 am

Re: RUT: positive or negative?

Post by Helico_expert » Wed Aug 28, 2019 1:17 pm

Yup. PBMT or PBAF are both good.

Sajal
Posts: 48
Joined: Tue Mar 05, 2019 5:54 pm

Re: RUT: positive or negative?

Post by Sajal » Wed Aug 28, 2019 11:08 pm

My GI has prescribed the following:

Esomeprazole 40 mg bid
Bismuth subcitrate 120 mg qid
Metronidazole 800 mg tid
Tetracycline 500 mg qid
Amoxicillin 1g tid.


I haven't heard of such combination. It seems pretty hard as it includes 3 antibiotics+ ppi+ bismuth and would have too many adverse effects. Moreover, I am also concerned about the dose of metronidazole.

Helico_expert
Site Admin
Posts: 3470
Joined: Wed Mar 02, 2011 7:20 am

Re: RUT: positive or negative?

Post by Helico_expert » Thu Aug 29, 2019 5:48 am

we gave something similar to extremely case before. However, I agree that metronidazole is a bit high. Do check with your doctor, he may be more experience than us in this combination.

Sajal
Posts: 48
Joined: Tue Mar 05, 2019 5:54 pm

Re: RUT: positive or negative?

Post by Sajal » Thu Aug 29, 2019 4:58 pm

Is it like adding Amoxicillin in the classic quadruple therapy i.e., PBMT therapy gives higher cure rate? If not, what is the purpose of adding an extra antibiotic to a standard regimen?
I think Amoxicillin has been added due to high metronidazole resistance here in India. Can Amoxicillin along with tetracycline be able to eradicate h pylori despite the fact that my h pylori strains are resistant to metronidazole?

Should I take it for the whole course of 14 days or I can stop it after 7 or 10 days?

Doctors here doesn't care about explaining anything to the patients. This is why your suggestions are very important.

Thankyou.

Helico_expert
Site Admin
Posts: 3470
Joined: Wed Mar 02, 2011 7:20 am

Re: RUT: positive or negative?

Post by Helico_expert » Fri Aug 30, 2019 6:34 am

more antibiotics = higher cure rate = more side effect

so, as long as you can tolerate the side effects, it's a good treatment. Your doctor will be responsible for your overall health and condition. So call him if you experience very bad side effects.

Sajal
Posts: 48
Joined: Tue Mar 05, 2019 5:54 pm

Re: RUT: positive or negative?

Post by Sajal » Sat Oct 05, 2019 12:20 am

Last therapy I took was a classic quadruple therapy i.e., metronidazole, tetracycline, bismuth subcitrate, esomeprazole plus amoxicillin. So basically it was rather penta therapy.
I haven't heard of such combination. Also, I have heard that Amoxicillin and tetracycline should not be used together as it hampers each other's efficacy. Is it true?

Helico_expert
Site Admin
Posts: 3470
Joined: Wed Mar 02, 2011 7:20 am

Re: RUT: positive or negative?

Post by Helico_expert » Sat Oct 05, 2019 4:49 pm

Yea, we use that combination before. It's ok.

amoxicillin and tetracyclin is a funny combination. The outcome differ from reporters. The success rate range from 40-90%. Not sure why. anyway, in your penta treatment, there will be other antibiotics that will work.

Sajal
Posts: 48
Joined: Tue Mar 05, 2019 5:54 pm

Re: RUT: positive or negative?

Post by Sajal » Thu Oct 31, 2019 7:36 pm

My follow-up test(RUT) came positive today.

Last abx: classic bismuth based quadruple therapy along with Amoxicillin.

Can someone please tell me where can I have antibiotics susceptibility test here in India?

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