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Third line treatment suggestions, help please !

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photon
Posts: 18
Joined: Sat Jun 11, 2016 6:11 am

Third line treatment suggestions, help please !

Post by photon » Fri Jul 01, 2016 9:09 am

Hello everyone. I had h pylori in the past (2 years ago) I think i eradicated it but it grew back little by little or now i have a reinfection..not sure. So I want to try a third line treatment, Could you please kindly tell me which one would be more effective?

1st treatment: amoxicillin, Clarithromycin , esomeprazole twice x20mg did not comply , dont know if it was effective, didnt test
2st treatment: tetracicline,metronidazol, esomeprazola twice x20mg did comply, it was effective it seems, negative stool test

2 years later: positive stool test, blood test

which one would be an effective third line treatment assuming its the same bacteria (ive been having symptoms after the 2nd treatment getting worse to this date):

3rd: tetracicline, Furazolidone, lanzoprazole x2 30mg, bismuth

or

amoxcillin, furazolidone, bismuth, lanzoprazole x2 30mg

or

amoxicllin, levaquine, lanzoprazole, bismuth?

Can i use bismuth in all cases? are these combinations okay? not sure if tetracicline and amoxicillin can be used again. Is there a more effective third line treatment? It seems tetracicline, furazolidone is more effective in my country? but not sure if im already resistant to tetracycline.

Helico_expert
Site Admin
Posts: 3047
Joined: Wed Mar 02, 2011 7:20 am

Re: Third line treatment suggestions, help please !

Post by Helico_expert » Sat Jul 02, 2016 12:55 pm

H. pylori will never become resistant to amoxicillin and bismuth. So you can always try to combine PPI + Amox + Bis + one more antibiotic (eg. levofloxacin or rifampicin or Frazolidone).

the side effect strength goes like this
Furazolidone > rifampicin > levofloxacin

so i would recommend levoflox first, then rif then only furazolidone.

Then again, everyone experience differently on the side effects.

another tip, increasing PPI dose can boost cure rate too.

photon
Posts: 18
Joined: Sat Jun 11, 2016 6:11 am

Re: Third line treatment suggestions, help please !

Post by photon » Sat Jul 02, 2016 8:32 pm

thank you so much helico_expert. I found a doctor who knows about this stuff. He wont prescribe the same antibiotics even though it might be a new infection or new strain just to make sure.

By high dosage PPI which one and how high do you mean? Is lanzoprazole x30mg b.i.d okay? or does it have to be esomeprazole or other type?

Helico_expert
Site Admin
Posts: 3047
Joined: Wed Mar 02, 2011 7:20 am

Re: Third line treatment suggestions, help please !

Post by Helico_expert » Mon Jul 04, 2016 10:20 pm

it can be any PPI. For lansoprazole, 30mg BID is fine.

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