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Re: Advice for persistant H. pylori

Posted: Mon Jul 06, 2020 9:43 am
by Helico_expert
your gastroenterologist probably knows better about the local strains.
If he had PBTC worked before, then go ahead a try that.
otherwise, I would recommend PBAC

P = PPI (eg rabeprazole 20mg TID)
B = bismuth (240mg QID)
T = tetracycline
C = ciprofloxacin or levofloxacin
A = Amoxicillin (1g TID)

Re: Advice for persistant H. pylori

Posted: Mon Jul 06, 2020 2:20 pm
by connaki
Thanks again - yes the reason for not using Amoxicillin is that I "may" be allergic to it - I am having a skin prick test in September (being in Melbourne doesnt make it easy - especially with the COVID cases on the rise)!

One final question - I have Bismuth subsalicylate left over from my trip to the US last year.. I've seen it used in many papers, but a lot of papers also use Bismuth subcitrate - do you think I can used subsalicylate for subcitrate?

Re: Advice for persistant H. pylori

Posted: Mon Jul 06, 2020 10:17 pm
by Helico_expert
Bismuth comes in various compound form. They all work the same.

Perhaps you can try PBRC treatment.

R = rifabutin (150mg BID).

Re: Advice for persistant H. pylori

Posted: Tue Jul 07, 2020 9:07 pm
by connaki
Thanks again for the advice - he has prescribed me for 14 days:

*20mg nexium (three times a day)
*500mg levofloxacin (twice a day)
*500mg tetracycline (four times a day)

I'm going to add Bismuth subsalicylate (262mg twice a day) - is that a good dose?

In addition, all research papers I've seen only use 500mg levofloxacin once a day - should I take it twice a day as suggested??

Thanks again!

Re: Advice for persistant H. pylori

Posted: Wed Jul 08, 2020 11:55 am
by Helico_expert
your doctor is responsible for your overall well being.

before you do any change, please consult your doctor.

we prescribe 240mg bismuth, 4 times a day.

Re: Advice for persistant H. pylori

Posted: Wed Jul 08, 2020 7:12 pm
by connaki
Ok - thanks again - I'll update you on how I go!

Re: Advice for persistant H. pylori

Posted: Sun Sep 20, 2020 5:54 pm
by connaki
Ok - unfortunately I have failed YET ANOTHER round of antibiotics.. Its really hard to stay positive about this now!

The gastroenterologist has now recommended treatment with 40mg bid esomeprazole, 200mg bid furazolidone and 500mg qid tetracycline (I might be allergic to amoxicillin, I had a very minor reaction as a child, and due to COVID I havent been able to do an allergy test - I'm based in Melbourne, AUS).

He has also gotten me to have a blood test to check my G6PD (glucose-6-phosphate dehydrogenase) before the regimen - for furazolidone.

What are your thoughts on this treatment helico_expert?

Thanks as always!

Re: Advice for persistant H. pylori

Posted: Sun Sep 20, 2020 9:01 pm
by Helico_expert
It's a good treatment. But it will be better if you can include bismuth in your treatment.

Re: Advice for persistant H. pylori

Posted: Mon Sep 21, 2020 8:10 pm
by connaki
Thank you - I will ask my gastroenterologist to add bismuth - i'll keep you updated :)