Antibiotics resitance

[sl88er]

I have done already first treatment

Metronidazol plus Clarythromycin plus Pantoprazole over 10 days and its failed...

So now probably I have double resistance... My question is why at all antibiotics which can cause resistance are used as first line treatment... Why take tahat antibiotcs as oral tretment at all... I will be very happy to have some topical tretment even over few hours to avoid antimicrobial resistance which can be achived not only by HP but also by others bugs... As I have very strong immun system it probably do not make differnce for me, but I will be carier of antibiotics resitant bugs which can make some problem to others... Maybe that kind of treatment will be more beneficial for common good...

And other question are... medicines should be taken after or before melas... doctors have diffrent opinions one some say ,,before,, some ,,after,,
How about dental Plaque...? there is a few Articels that confirm eradication of dental Plaque increase eradication rate, and few that say it is not true... who is right... Can HP survive in mouth in so unconvienient conditions...?
Do I need to take proton pump inhibitor after therapy with antibiotics... I saw a few paper that say that additional therapy with ppi after Antibiotics course have no benefits... is it only to ease potetional pain...? HCl generally should kill HP so maybe additional 2-3 weeks of ppi give that bug chance to recover...?
I really dont like idea to shoot down HCl and give chance not only HP but as well other buggers to gain some territorial benefits... Will it be wrong to throw away ppi just after end of second line tretment with antibiotics and ppi...?

thanks

[Helico_expert]

Why the antibiotic used in first line is always resistant? I think that's brilliant question. The answer is because these antibiotic is very common and affordable. To the general public, these antibiotics have a cure rate of at least 80%. if we use uncommon drugs in the very beginning, these uncommon drugs will become common and will too become resistant.

There is no exact answer to take the drugs before or after meal. you can have it either way. Perhaps after meal will prolong the drug in your stomach and increase the effectiveness? just a thought. no evidence. :p

DNA of H. pylori had been detected in the mouth. However it doesnt mean that H. pylori survives there. It is a very slow growing bacteria and so I dont think it can compete with other fast growing bacteria in the mouth. Therefore, I doubt the dental plague study.

Why take PPI? it is because most of the antibiotics are sensitive to acid. so we have to reduce the acid level in the stomach to increase the antibiotic effectiveness. Why take PPI after treatment? it is because some people has stomach ulcer. when the acid touches the ulcer, patient will feel the pain. so, the recommendation is to take PPI until the ulcer heal.

If H. pylori survive your antibiotic treatment, with of without HCl, it'll survive. It has the ability to neutralise acid. That's why it can live in your stomach.

to your last question, give up PPI? answer is no. because most antibiotics are sensitive to acid. The most effective way is to do an endoscopy, get the biopsy, grow the H. pylori, do antibiotic test, then apply antibiotics that will kill it. However, not everyone has the luxury for this kind of treatment.

[sl88er]

,,Why the antibiotic used in first line is always resistant? I think that's brilliant question. The answer is because these antibiotic is very common and affordable. To the general public, these antibiotics have a cure rate of at least 80%. if we use uncommon drugs in the very beginning, these uncommon drugs will become common and will too become resistant,,

yes, after that that antibiotics will be common in eradication treatment... but do you thing that resistance will be common ? For example in Poland Amoxicilin is very common and is given for many reasons... 80% of people got HP but no resistance was reported, the same situation is with tetracycline for which presription for even few month tretment is very oft given because of acne... I was thinking about using something like Tetracycline/Amoxicilin + Furazolidone + Bismuth + PPI which will do not provide resistance... I think doktor Graham is saying that kind of regimes provide essentaially 100% cure

http://www.ncbi.nlm.nih.gov/pubmed/22249084

Even when cure rate will be for example 90% in second attempt one should expect that chnaces with the same treatment should not much differ from first one ...

[Helico_expert]

absolutely. I cannot disagree with that. However, tetracycline cannot be easily access by many people. so is bismuth. a lot of country cannot get bismuth. besides, tetracycline and furazolidone are known for their side effects. We do prescribe them, but only when there is no other solution.

nevertheless, there is no resistance to these antibiotic now, doesnt mean they wont be resistant in the future. very rarely, we heard some reports about amoxicillin resistant H. pylori. we hope that we can obtain some of those strains and find out more about why H. pylori is resistant to amoxicillin.

[sl88er]

,,DNA of H. pylori had been detected in the mouth. However it doesnt mean that H. pylori survives there. It is a very slow growing bacteria and so I dont think it can compete with other fast growing bacteria in the mouth. Therefore, I doubt the dental plague study. ,,

http://onlinelibrary.wiley.com/doi/10.1 ... 0497.x/pdf


They do some bacterial culture from mouth and with positive outcome... They also find a few patients only with infection in mouth...

few more

http://www.ncbi.nlm.nih.gov/pubmed/12018924



It is really confusing...

[Helico_expert]

there are very few papers about successful culturing bacteria from mouth. We are currently trying but have no success. DNA was detected but... high false positive.