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Which antibiotic regime should I use now?

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ikpap
Posts: 5
Joined: Mon Apr 09, 2018 7:49 pm

Which antibiotic regime should I use now?

Post by ikpap » Mon Apr 09, 2018 8:21 pm

Hi,
I have known of my Helicobacter infection since last September - I initially had the standard triple therapy (esomeprazole, amoxicillin, clarithromycin) but symptoms persisted. I then had a gastroscope and biopsy confirmed I still had helicobacter (no culture was done). I was then put on Ciprofloxacin/esomeprazole and amoxicillin for 3wks - then had breath test 6wks later which was positive. Then had another gastroscope and biopsies sent for culture.
My culture results are Helicobacter pylori:
Resistant to Clarithromycin, levofloxacin and Metronidazole.
Sensitive to Amoxicillin, Rifampicin and Tetracycline.

Please can you help me with some advice on what drugs I should try next, as I really would like to get rid of this bug once and for all. I have an appt with my gastroenterologist next week but am trying to do all my homework first.

Thank you

Helico_expert
Site Admin
Posts: 2336
Joined: Wed Mar 02, 2011 7:20 am

Re: Which antibiotic regime should I use now?

Post by Helico_expert » Mon Apr 09, 2018 9:14 pm

You can try

Rabeprazole 20mg 3x a day
Bismuth 240mg 4x a day
Amoxicillin 1000mg 3x a day
Tetracycline 500mg 4x a day

ikpap
Posts: 5
Joined: Mon Apr 09, 2018 7:49 pm

Re: Which antibiotic regime should I use now?

Post by ikpap » Tue Apr 10, 2018 4:27 am

Thanks heaps for your reply.
Please can you advise where we get the Bismuth from in Australia - I have a pharmacist friend who said it's not available? Which type of bismuth are you referring to (is there a brand name? ) as my reading indicates there are different forms - bismuth subcitrate vs bismuth subsalycilate?

Also, is this regime affected by mealtimes - do the tablets need to be taken on an empty stomach or with food?

Also, how long a course should I be on - 14days?

Thank you so much

Helico_expert
Site Admin
Posts: 2336
Joined: Wed Mar 02, 2011 7:20 am

Re: Which antibiotic regime should I use now?

Post by Helico_expert » Tue Apr 10, 2018 8:31 am

In Australia, your pharmacist friend can order from http://trimed.com.au/

ikpap
Posts: 5
Joined: Mon Apr 09, 2018 7:49 pm

Re: Which antibiotic regime should I use now?

Post by ikpap » Wed Apr 11, 2018 4:36 am

Hi Heli-expert,

Thanks for all your advice.

I was wondering what you guys think about using N-acetyl Cystine as part of treatment for helicobacter. My reading indicates it might be beneficial? If so, would you use it before a course of therapy or at the same time? Dose?

Thanks

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

Re: Which antibiotic regime should I use now?

Post by Helico_expert » Wed Apr 11, 2018 1:48 pm

the function of N-acetyl Cystine is to reduce the mucous layer in the stomach. The idea is that H. pylori hides under the thick mucous and avoided the antibiotics. I think the reason why antibiotics is the only thing that work is because antibiotics get absorbed in the blood and attack H. pylori from behind the mucous later.

Also, 50% of the stomach ulcer is caused by NSAIDs (pain killer). The reason is because NSAIDs can too reduce the mucous layer, which the stomach acid can then attack the stomach wall.

Also, the reason why intestinal metaplasia (pre-cancer) is reversible, is because these intestinal cells growing in the stomach dont produce mucous and can be cleaned up by the stomach acid.

Lastly, the triple and quadruple therapy, if used correctly, have a cure rate of over 90%. So I dont think there is a need to use N-acetyl Cystine at the moment.

ikpap
Posts: 5
Joined: Mon Apr 09, 2018 7:49 pm

Re: Which antibiotic regime should I use now?

Post by ikpap » Wed Apr 11, 2018 2:17 pm

Thank you! I am very relieved to hear you say that intestinal metaplasia is reversible, because my biopsies showed I had it, and I was very worried and stressed about the cancer risk.

Cheers

Helico_expert
Site Admin
Posts: 2336
Joined: Wed Mar 02, 2011 7:20 am

Re: Which antibiotic regime should I use now?

Post by Helico_expert » Wed Apr 11, 2018 6:34 pm

it is reversible. however, you should get a follow up endoscopy check up one year later.

ikpap
Posts: 5
Joined: Mon Apr 09, 2018 7:49 pm

Re: Which antibiotic regime should I use now?

Post by ikpap » Wed Apr 18, 2018 7:06 pm

Hi,
I was wondering what I should do about my children - I am worried I may have infected them and that they may have my hp infection now? What should I do?

Thanks

Helico_expert
Site Admin
Posts: 2336
Joined: Wed Mar 02, 2011 7:20 am

Re: Which antibiotic regime should I use now?

Post by Helico_expert » Thu Apr 19, 2018 9:45 pm

Children are normally not affected by HP. However, to prevent potential reinfecrion from them, you should not share food with them.

Keep their oral clean by brushing their teeth should be good enough to reduce transmission risk.

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