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Cefixime 200mg twice a day + 20mg omeprazole twice a day for suspected H pylori

The most popular treatments consist of two antibiotics (one of which is usually clarithromycin) plus a strong acid blocker such as omeprazole (PriLosec, Nexium, Somac, Zoton, etc.). Treatment is for 7-10 days. Cure rate is about 85%

Moderators: Toni, barjammar, luci2010, Ondek-Expert, kkimura

Myrad56
Posts: 18
Joined: Fri May 29, 2020 12:22 pm

Re: Cefixime 200mg twice a day + 20mg omeprazole twice a day for suspected H pylori

Post by Myrad56 »

Helico_expert wrote:
Wed Jul 08, 2020 11:53 am
you can continue omeprazole or ranitidine or both.
some people take them for years.

I think you just finish the current course of treatment and then see how it goes
Treatment was completed today(total 28 tablets of cefixime 200mg and 28 capsules of Omeprazole with intermittent Ranitidine 150mg tablets), whats next ?

The current status of my burning belly pain is uncertain being masked by a high PPI dose. Although every now and then some negligible sensation does come but out of habit I have somehow resumed tea and fried foods also some mild to moderate spicy foods which I will reduce now since the burning pain in the belly might come back.

Somedays I get black tarry stools which I think could be bile acid instead of blood because the stool is loose and mushy as well.

Overall I will say maybe upto some extent I have had some noticeable improvement but not enough to adopt it as a treatment. If there is a H Pylori infection in my stomach then it most possibly failed to eradicate it.

I have decided to start Rabeprazole 20mg BID until I get tested for H Pylori since I don't think 150mg Ranitidine will do much and I fear boneloss from omeprazole.

I know the standard treatment for H Pylori is amoxicilin+clarithromycin/metronidazole+esomeprazole and that's why I am looking forward to getting myself tested for H Pylori and then visiting a gastroenterologist to get a prescription for this treatment but I also assume that the heavy antibiotic dosage in this standard treatment will be intolerable for me.

What do you think I should do next after completing this cefixime+omeprazole treatment ?

Helico_expert
Site Admin
Posts: 4110
Joined: Wed Mar 02, 2011 7:20 am

Re: Cefixime 200mg twice a day + 20mg omeprazole twice a day for suspected H pylori

Post by Helico_expert »

I think you should get a follow up test for H. pylori before taking any more antibiotics.

However, since most follow up test is affected by PPI, such as rabeprazole, you will have to stop PPI for at least 2 weeks before the follow up test.

Then again, ranitidine or any other H2 blockers will not interfere with follow up test. This is because these H2 blockers they are fast acting but short active life in the body.

So, if you still have reflux or pain symptom, you can either continue rabeprazole for another 2 weeks, then switch to ranitidine for two weeks, then get follow up test.

or, start ranitidine straight for two weeks, then get follow up test.

Myrad56
Posts: 18
Joined: Fri May 29, 2020 12:22 pm

Re: Cefixime 200mg twice a day + 20mg omeprazole twice a day for suspected H pylori

Post by Myrad56 »

Rabeprazole 20mg BID, right ?

Helico_expert
Site Admin
Posts: 4110
Joined: Wed Mar 02, 2011 7:20 am

Re: Cefixime 200mg twice a day + 20mg omeprazole twice a day for suspected H pylori

Post by Helico_expert »

Rabeprazole 20 mg BID is fine.
most importantly, do you feel that it's helpful? if not, you can ask your doctor for TID to try out.

Myrad56
Posts: 18
Joined: Fri May 29, 2020 12:22 pm

Re: Cefixime 200mg twice a day + 20mg omeprazole twice a day for suspected H pylori

Post by Myrad56 »

Helico_expert wrote:
Tue Jul 14, 2020 1:22 pm
Rabeprazole 20 mg BID is fine.
most importantly, do you feel that it's helpful? if not, you can ask your doctor for TID to try out.

Do you think PPI alone can have some effect on H Pylori if taken in high dose like TID ?

Helico_expert
Site Admin
Posts: 4110
Joined: Wed Mar 02, 2011 7:20 am

Re: Cefixime 200mg twice a day + 20mg omeprazole twice a day for suspected H pylori

Post by Helico_expert »

PPI can reduce H. pylori load. But it cannot remove the H. pylori. As long as there is H. pylori, you will always have inflammation, and your condition will never improve.

Myrad56
Posts: 18
Joined: Fri May 29, 2020 12:22 pm

Re: Cefixime 200mg twice a day + 20mg omeprazole twice a day for suspected H pylori

Post by Myrad56 »

Helico_expert wrote:
Tue Jul 14, 2020 8:49 pm
PPI can reduce H. pylori load. But it cannot remove the H. pylori. As long as there is H. pylori, you will always have inflammation, and your condition will never improve.
Some Burning sensation in the belly is back today after two days of stopping antibiotics, yesterday I took ranitidine 150mg twice a day.

Helico_expert
Site Admin
Posts: 4110
Joined: Wed Mar 02, 2011 7:20 am

Re: Cefixime 200mg twice a day + 20mg omeprazole twice a day for suspected H pylori

Post by Helico_expert »

hopefully it's just one of those flare up episodes. You can continue ranitidine whenever you need and stop whenever you want.

Remember to get a follow up test 2 weeks after stopping omeprazole/rabeprazole/antibiotics.

Myrad56
Posts: 18
Joined: Fri May 29, 2020 12:22 pm

Re: Cefixime 200mg twice a day + 20mg omeprazole twice a day for suspected H pylori

Post by Myrad56 »

Helico_expert wrote:
Wed Jul 15, 2020 1:35 pm
hopefully it's just one of those flare up episodes. You can continue ranitidine whenever you need and stop whenever you want.

Remember to get a follow up test 2 weeks after stopping omeprazole/rabeprazole/antibiotics.
I assume you have some hope that cefixime had some effect on my presumed H pylori ? Do you think that cefixime could've eliminated H pylori upto some extent? As per my symptoms now I feel like cefixime had absolutely zero impact on the presumed infection because once again I can't sustain without taking a high dose of antacids, for the last two days I have had to take at least 3-4 tablets of Ranitidine 150mg per day out of the recurring burning sensation in the belly !

Will esomeprazole 20mg BID be a better PPI than Rabeprazole?

I am back on my normal tea/pickle/spicy foods diet that I am intentionally taking to see any improvements.

Helico_expert
Site Admin
Posts: 4110
Joined: Wed Mar 02, 2011 7:20 am

Re: Cefixime 200mg twice a day + 20mg omeprazole twice a day for suspected H pylori

Post by Helico_expert »

we had one patient who took the antibiotic for one day, got allergy reaction and stopped treatment. He was surprisingly cured one just one day treatment. So even 1% cure rate is better than zero. Hopefully your cefixime would work.

esomeprazole, pantoprazole or rabeprazole, anyone of them is fine. Everyone digest them differently. So it depends on how your body react on them. If you find esomeprazole effective, just keep using it. Otherwise, give another brand a trial.

Dont push too hard on yourself on trying different food. Assuming that your H. pylori is eradicated, your stomach still needs time to recover.

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