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Recommendations for Refractory H. Pylori Treatment

The cure of Hp usually requires antibiotics. Other things have been tried and have a weaker effect.

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

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mjfuter
Posts: 16
Joined: Mon Nov 02, 2020 8:10 am
Contact:

Recommendations for Refractory H. Pylori Treatment

Post by mjfuter »

BACKGROUND:

I was diagnosed with a Helicobacter Pylori (H. Pylori) infection in my stomach by upper GI endoscopy back on July 1, 2020 after nearly a year of being undiagnosed, losing 75+ lbs. of body weight and living in constant pain with low-grade fevers, night sweats and chills.

Since receiving a diagnosis, I've taken multiple rounds of combination antibiotics therapy for my infection. They include:

2 x 14-day rounds of clarithromycin triple therapy (generic PrevPac)
2 x 10-day rounds of Pylera (bismuth quadruple therapy)
1 x 14-day round of bismuth quadruple therapy (generic Pylera)
2 x 14-day rounds of Talicia (rifabutin, amoxicillin and high-dose omeprazole)

Though my health has improved about 70%-80% since completing over 13 weeks of treatment, I've decided to continue with therapy until the H. Pylori infection is fully eradicated and I'm feeling 100% again.

I'm currently on my third 14-day round of Talicia therapy which I will complete in 4-5 days.

QUESTION(S):

1. Have any of you suffered from a refractory H. Pylori infection? If so, what combination antibiotics therapy did you use to eventually eradicate it?
2. Have any of you taken Talicia therapy? If so, was it effective?
3. Can the H. Pylori urea breath test or stool antigen test produce false negatives under certain circumstances?

Thank you for reading this post and providing your helpful feedback!

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

Re: Recommendations for Refractory H. Pylori Treatment

Post by Helico_expert »

The key to successful treatment is strong PPI.
Omeprazole used in Talicia is probably not strong enough. Perhaps you can ask your doctor for even stronger ones like Rabeprazole 20mg three times a day.

You can also boost your treatment by adding bismuth, eg pepto bismol.

Answer to your questions
1. it's not easy for adults to be reinfected. unless everyone under the same roof is not hygienic and doesnt brush teeth. you have tried almost all types of antibiotics except for ciprofloxacin and furazolidone.

2. Talicia is quite new. so we dont have experience about it. But we have used rifabutin, bismuth, amoxicillin and rabeprazole combination and gave very good outcome.

3. breath and stool tests are depending on bacteria load. If you take PPI or antibiotics or any herbs that may affect HP growth, then you will get false negative result. That's why before breath/stool test, you need to stop PPI and any other medication for four weeks.

Sajal
Posts: 72
Joined: Tue Mar 05, 2019 5:54 pm

Re: Recommendations for Refractory H. Pylori Treatment

Post by Sajal »

mjfuter wrote:
Mon Nov 02, 2020 8:26 am
BACKGROUND:

I was diagnosed with a Helicobacter Pylori (H. Pylori) infection in my stomach by upper GI endoscopy back on July 1, 2020 after nearly a year of being undiagnosed, losing 75+ lbs. of body weight and living in constant pain with low-grade fevers, night sweats and chills.

Since receiving a diagnosis, I've taken multiple rounds of combination antibiotics therapy for my infection. They include:

2 x 14-day rounds of clarithromycin triple therapy (generic PrevPac)
2 x 10-day rounds of Pylera (bismuth quadruple therapy)
1 x 14-day round of bismuth quadruple therapy (generic Pylera)
2 x 14-day rounds of Talicia (rifabutin, amoxicillin and high-dose omeprazole)

Though my health has improved about 70%-80% since completing over 13 weeks of treatment, I've decided to continue with therapy until the H. Pylori infection is fully eradicated and I'm feeling 100% again.

I'm currently on my third 14-day round of Talicia therapy which I will complete in 4-5 days.

QUESTION(S):

1. Have any of you suffered from a refractory H. Pylori infection? If so, what combination antibiotics therapy did you use to eventually eradicate it?
2. Have any of you taken Talicia therapy? If so, was it effective?
3. Can the H. Pylori urea breath test or stool antigen test produce false negatives under certain circumstances?

Thank you for reading this post and providing your helpful feedback!






Are you on your 8th round of abx? Don't you think taking this much antibiotics in such short course of time is dangerous?
I myself have tried 5 rounds so far but that is within a time span of almost 2 years. I too can say I am only 50-60 percent improved.

CheerfulSatchel
Posts: 25
Joined: Fri Oct 30, 2020 9:40 pm

Re: Recommendations for Refractory H. Pylori Treatment

Post by CheerfulSatchel »

I’ve recently come across Zinc Carnosine as something for helping gastritis and ulcer healing. There was a thread here:

https://healthunlocked.com/pasoc/posts/ ... ntagonists

Helico_expert, do you have any information on zinc carnosine as a post treatment helper for H Pylori damage or even as a complete PPI replacement?

Thank you! :]

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

Re: Recommendations for Refractory H. Pylori Treatment

Post by Helico_expert »

Honestly, no experience about it. But a few literature showed that it's safe. So I guess there is no harm trying.

mjfuter
Posts: 16
Joined: Mon Nov 02, 2020 8:10 am
Contact:

Re: Recommendations for Refractory H. Pylori Treatment

Post by mjfuter »

Helico_expert wrote:
Mon Nov 02, 2020 10:15 am
The key to successful treatment is strong PPI.
Omeprazole used in Talicia is probably not strong enough. Perhaps you can ask your doctor for even stronger ones like Rabeprazole 20mg three times a day.

You can also boost your treatment by adding bismuth, eg pepto bismol.

Answer to your questions
1. it's not easy for adults to be reinfected. unless everyone under the same roof is not hygienic and doesnt brush teeth. you have tried almost all types of antibiotics except for ciprofloxacin and furazolidone.

2. Talicia is quite new. so we dont have experience about it. But we have used rifabutin, bismuth, amoxicillin and rabeprazole combination and gave very good outcome.

3. breath and stool tests are depending on bacteria load. If you take PPI or antibiotics or any herbs that may affect HP growth, then you will get false negative result. That's why before breath/stool test, you need to stop PPI and any other medication for four weeks.
Hi Helico_expert,

I'm scheduled to meet with my GI specialist on Thursday 12/3 and he's requesting that I bring him new H. Pylori treatment suggestions based on my own research. He's willing to continue treating my H. Pylori infection, but is only familiar with the standard PrevPac, Pylera, and Talicia therapies that I've already failed.

In your expert opinion, what is the next stronger antibiotics/PPI/bismuth treatment regimen for someone like me who's already failed PrevPac, Pylera and Talicia? Please include number of days, frequency per day, dosage amounts, etc. so that my doctor can review and then send a prescription to a local pharmacy.

I really appreciate all of your help! You're a lifesaver!

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

Re: Recommendations for Refractory H. Pylori Treatment

Post by Helico_expert »

which means you have tried almost everything except quinolones and furazolidon.

it would be best if you can get a culture susceptibility test before the next treatment.

otherwise, these are the possible next treatment
Rabeprazole 20mg TID
bismuth 240mg QID
Amoxicillin 1g TID
and either levofloxacin or furazolidon

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