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Some useful guides
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Management of Helicobacter pylori infection—the Maastricht V/Florence Consensus Report
The 5th Chinese Helicobacter treatment consensus
How long should I wait before doing follow up breath/stool test?

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Antibiotic Resistance

The various unpleasant manifestations of Helicobacter can be described here. Remember however that the great majority of persons with Hp have no symptoms that they are aware of and consider themselves normal.

Moderators: barjammar, Toni

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Plotun
Posts: 59
Joined: Sun Sep 27, 2020 2:48 am

Antibiotic Resistance

Post by Plotun »

Hello.

What are eradication rates if H.Pylori is resistant to just one of two instead of two antibiotics in the regimen?

An example: Levofloxacin plus Metronidazole combination. If H.Pylori is suscetible to Levofloxacin and resistant to Metronidazole, would it be enough to eradicate the bug?

AMERC
Posts: 111
Joined: Mon Dec 07, 2020 5:23 am

Re: Antibiotic Resistance

Post by AMERC »

Thats interesting question. I guess given that people like myself fail despite trying different antibiotics we need both to work.

Question from me is what if multiple therapy treatments failed. What is the measure of last resort or do we just live with h pylori, and manage symptoms via PPI and antacid?

Helico_expert
Site Admin
Posts: 4600
Joined: Wed Mar 02, 2011 7:20 am

Re: Antibiotic Resistance

Post by Helico_expert »

Interesting question.

I think the more relevant question is how likely is H. pylori become resistant to the antibiotic.
base on our experience, metronidazole, ciprofloxacin, rifabutin, and clarithromycin are very easily to become resistant to
tetracycline, amoxycillin, furazolidone, and bismuth are very difficult to become resistant to.

So base on the combination of the antibiotics, you can still get good cure rate if your HP is only resistant to one of the easy antibiotic.

Second question is also very interesting.
H. pylori can lead to chronic inflammation. While most of the symptoms are caused by the acid, taking PPI can solve the symptomatic problem. But the chronic inflammation can lead to more problematic damage in the future, including cancer. So we dont recommend to leave it.

we do have cases where the patient tried every possible combination of antibiotics treatment and yet not able to get rid of H. pylori. There is no guideline to how to cure them. We ourselves are experimenting. Some researchers are suggesting to wait for a year, and then repeat the treatment. The idea is that the resistant strain is less fit compare to the wild type. So eventually they will revert to sensitive variant again. And then you can try the treatment again.

ronaldo99
Posts: 6
Joined: Fri Sep 15, 2023 12:59 pm

Re: Antibiotic Resistance

Post by ronaldo99 »

Good question! Although H. Pylori resistance to one antibiotic in a two-drug treatment reduces the rate of eradication,Buckshot Roulette individual circumstances make it difficult to pinpoint the precise success rate.

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