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欧洲幽门螺杆菌治疗共识 5

2nd line treatment with Levofloxacin

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Joined: Tue Dec 17, 2019 7:34 am

2nd line treatment with Levofloxacin

Post by Deejay202 »

Hi there,

I did a H.pylori Urea breath test back in October and had a 1173 dpm (C14) reading which indicated positive for H. Pylori. I started on Nexium Hp7 (first line treatment). I got tested 1 month later with a 2479 dpm (C14) reading. It seems like the H.pylori doubled in number? Or is the reading not actually reflective of how much bacteria there is? My GP subsequently referred me to a gastroenterologist, in which is prescribed me:

- 20mg esomeprazole / 2 times daily
- 1000mg amoxycillin / 2 times daily
- 500mg Levofloxacin / 2 times daily

I have researched into Levofloxacin and it is termed an antibiotic that should only be used if all other antibiotics have failed. Apparently in the US at the moment, there has been several court cases with victims getting permanent damage from the use of Levofloxacin (or fluoroquinolones). Some of these include tendon problems and nerve damage (permanent).

Also I want to note that most of the time I do not have symptoms, I normally get symptoms after a big night of drinking or if I do not eat properly.

I feel the gastroenterologist has prescribed me therapy consistent of a more 3rd line treatment option (rather than 2nd line). I am worried to take levofloxacin if I do not really need it, due to the potentially damaging side effects.

Do you suggest that a more safer 2nd line treatment such as the following quadruple therapy should be prescribed?

- 20mg omeprazole / 1 time daily
- 120mg Bismuth Subsalicylate / 4 times daily
- 400mg metronidazole / 3 times daily
- 500mg tetracycline / 4 times daily

Or do you recommend that I stop worrying / thinking so much and just take what the gastroenterologist has prescribed me?

Thank you so much for your help!

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Re: 2nd line treatment with Levofloxacin

Post by Helico_expert »

Levofloxacin May cause damage to tendon. So don’t do extreme sport while you are having it.

Amoxicillin and Levofloxacin are good combination. It would be better if you can add pepto bismol in this regimen.

All antibiotics consist of certain degree of risk. For example, metronidazole is consider as carcinogen but doctors still prescribe it widely.

I think you can try your doctor’s recommendation first, with addition if pepto bismol and perhaps increase the esomeprazole from 2 times a day to 3 times a day.

If that failed, then you can try the tetracycline metronidazole combination.

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