Only registered users are allowed to post. To register, please click here

Should you have any problem in posting, registering, or login, please do not hesitate to contact the admin.

Advertisement is not allowed. While we encourage discussion, please try not to promote your website, goods, or unproven treatment here.

This is a non-profit website. We will try our best to help anyone that has question about H. pylori and their treatment. We shall provide the most accurate answer about H. pylori. You can help us by clicking here to keep this forum alive.

Some useful guides
How to post in the forum?
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?



此网站免费然您阅读。若想分享心得或提问,请先注册
若有困难注册,请联络站长
此网站不允许打广告。我们欢迎任何的讨论。但尽量不要推销没医学根据的网站,商品或治疗方案。
此网站是非盈利网站。我们会尽最大能力提供任何有关幽门螺杆菌的讯息。您的捐款可以让我们继续帮助更多的病人。

指南
如何贴文?
欧洲幽门螺杆菌治疗共识 5
第五次全国幽门螺杆菌感染处理共识报告
用药后,多久以后可以再做吹气测试?

Extremely low stomach acid

After first line treatment, various "second line" treatments can be used. The policy for H.pylori is: Make sure the infection is real (breath test for follow-up). Always give a high dose of PPI (acid blocker) when using amoxicillin. In the second treatment, give a different drug in place of clarithromycin.

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

Chonibashi12
Posts: 14
Joined: Thu Feb 20, 2020 6:59 am

Re: Extremely low stomach acid

Post by Chonibashi12 »

No I have not taken rifabutin, levofloxacin, doxycycline or Nitazoxanide before.

Would the other drugs interact with rifabutin in anyway? Would it not boost the cure rate?

Helico_expert
Site Admin
Posts: 3641
Joined: Wed Mar 02, 2011 7:20 am

Re: Extremely low stomach acid

Post by Helico_expert »

All these antibiotics come with some degree of damages to your liver and side effects. Let's not try the extreme while you can use the quadruple therapy i mentioned.

Chonibashi12
Posts: 14
Joined: Thu Feb 20, 2020 6:59 am

Re: Extremely low stomach acid

Post by Chonibashi12 »

You are extremely helpful, I appreciate it very much.

I have gotten a second opinion from another doctor who has recommended the following, it turns out Rifabutin and Nitazoxanide are not available in the UK.

Rabeprazole 40mg
Levofloxacin 500mg
Tinidazole 500mg
Amoxicillin 1g
Bismuth 300mg

All of the above twice a day for 14 days, there is a strong study in the above regimen: https://www.gastrojournal.org/article/S ... X/abstract

Please can you advice on any changes?

Thank you once again Helico Expert

Helico_expert
Site Admin
Posts: 3641
Joined: Wed Mar 02, 2011 7:20 am

Re: Extremely low stomach acid

Post by Helico_expert »

In the article you have just shared.. the two groups used quadruple therapy, that is PPI + Amox + Levo + tini.

The medications you listed consist of 5 drugs.
PPI + Bis + Amox + Levo + tini

I guess bismuth is not very harmful. so you can use it to give this treatment a boost.
It is very important that you have never taken levofloxacin, or ciprofloxacin or moxifloxacin or any other quinolones. They are all the same class.
similarly, tinidazole and metronidazole are the same class.

So the above treatment wont work if you have taken metronidazole or quinolones before.

lastly,
I assume you meant rabeprazole 40mg twice a day, as long as your doctor approves it. then it's ok. otherwise, it should be 20mg 3 times a day
you can increase Amoxicillin 1g to 3 times a day.
you can also increase bismuth 300mg to 3 times a day.

Chonibashi12
Posts: 14
Joined: Thu Feb 20, 2020 6:59 am

Re: Extremely low stomach acid

Post by Chonibashi12 »

Hello Helico Expert,

I just realised that I have taken Metronidazole in my second treatment, what would be my next option considering I have not used Levofloxacin before. Maybe higher dose levofloxacin and amoxicillin and PPI 3 times a day for 10-14 days?

I have used: clarithromycin, tetracycline and metronidazole.

Please if you can advice I would be extremely grateful.

Thank you

Helico_expert
Site Admin
Posts: 3641
Joined: Wed Mar 02, 2011 7:20 am

Re: Extremely low stomach acid

Post by Helico_expert »

In that case you can try PBAC

Rabeprazole 20mg three times a day
Bismuth 300mg three times a day
Amoxicillin 1g three times a day
levofloxacin 500mg two times a day

Please remember that you should always get a doctor to monitor your side effects.

Chonibashi12
Posts: 14
Joined: Thu Feb 20, 2020 6:59 am

Re: Extremely low stomach acid

Post by Chonibashi12 »

Hello Helico Expert hope you are doing good.

I just had a question that was bothering me for a while, I hope you could answer it please.

If I undertake a h pylori culture, and it shows for example that my h pylori is sensitive to clarithromycin, would that mean I am able to take the drug again with a different approach? Or would the result be useless since I have already taken that drug in my 1st treatment?

Besides I know it’s difficult to culture H pylori even my doctor said it’s only about 50% successful in the UK.

Thank you for your support

Helico_expert
Site Admin
Posts: 3641
Joined: Wed Mar 02, 2011 7:20 am

Re: Extremely low stomach acid

Post by Helico_expert »

Yes. if the lab is able to culture your HP and it showed that it is sensitive to Clarithromycin, then you are allowed to repeat the use of Clarithromycin even if you had it before.

That's why it is important to do this test.

It is well known that the HP is hard to culture. But if they have the right person, they can do it. Our lab has a culture success rate of over 90%. The labs that we trained also able to achieve similar results.

Post Reply

Return to “Ideas for Resistant H.pylori Infections”