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RUT: positive or negative?

There are several types of tests for H.pylori. The major ones have a their own forum.

Moderators: Toni, barjammar

Sajal
Posts: 62
Joined: Tue Mar 05, 2019 5:54 pm

Re: RUT: positive or negative?

Post by Sajal »

"Resistance to ppis"—I haven't heard about it. Does it mean that esomeprazole won't suppress acid secretion? As far as I know, esomeprazole very well work for me as far as suppressing stomach acid is concerned like any other ppis. Also, I have used rabeprazol(20mg tid) in my last round of abx(rifabutin+amoxicillin) but in vain.

I understand that ppis plays a vital role as strong inhibition of gastric acid secretion is crucial for h pylori eradication. Thing is, I have only tried second generation ppis i.e., rabeprazol and esomeprazole in all my eradication regimens so far. Should I try a first generation ppis such as Omeprazole, lansoprazole etc. this time?

I am aware that increasing the dose and number of pills of ppis improves the eradication rate though not significantly. What ppis should I try this time and what would be its 'very high dose'?

Also, I was wondering if 750mg amoxicillin qid would serve the purpose because in my last abx I have had used1g of amoxicillin tid ? Should I increase it to 1g qid this time?

Helico_expert
Site Admin
Posts: 3866
Joined: Wed Mar 02, 2011 7:20 am

Re: RUT: positive or negative?

Post by Helico_expert »

If you feel well after esomeprazole, then it's ok.
perhaps you should try find out if there is someone that can do antibiotic sensitivity testing? perhaps some of the medications that you have used before can be reused.

Sajal
Posts: 62
Joined: Tue Mar 05, 2019 5:54 pm

Re: RUT: positive or negative?

Post by Sajal »

Unfortunately, in India antibiotics susceptibility test is not available. I guess I have try on my own.

What about the question I raised regarding the ppis in the last post?

Helico_expert
Site Admin
Posts: 3866
Joined: Wed Mar 02, 2011 7:20 am

Re: RUT: positive or negative?

Post by Helico_expert »

you should avoid omeprazole.

stick to either esomeprazole or rabeprazole.

Sajal
Posts: 62
Joined: Tue Mar 05, 2019 5:54 pm

Re: RUT: positive or negative?

Post by Sajal »

Will esomeprazole 20 mg qid be able to reach the required ph in stomach for amoxicillin to work?

Helico_expert
Site Admin
Posts: 3866
Joined: Wed Mar 02, 2011 7:20 am

Re: RUT: positive or negative?

Post by Helico_expert »

Good question. I have not actually measure it myself. So I dont know. But 20mg is definitely a very high dose used in some studies.

Sajal
Posts: 62
Joined: Tue Mar 05, 2019 5:54 pm

Re: RUT: positive or negative?

Post by Sajal »

Here I am again with the same question: what abx should I try this time. Have had 4 round of abx–
-:(amox+clarithro+ppis)
-:(metro+tetra+amox+bismuth+ppis)
:-(amox+rifabutin+bismuth+ppis)
:-(amox750mg qid+bismuth+ esomeprazole 20mg qid)

The only antibiotic that I haven't tried and which is available in my country is levofloxacin. I want the best possible combination this time as I would left with no options after that. Thing is, I have used Amoxicillin every time in my previous abx therapies; I am suspicious that It doesn't work for me. Can I try levofloxacin with tetracycline this time? I have tried tetracycline once. What is the possibility of acquired resistance of tetracycline?

I cannot live with this bug. It is ruining my entire life. This is the most precious time of my life.

There is no antibiotic susceptibility test is available here in India. What can I do here? I am confused between amoxicillin and tetracycline.

Helico_expert
Site Admin
Posts: 3866
Joined: Wed Mar 02, 2011 7:20 am

Re: RUT: positive or negative?

Post by Helico_expert »

You can try rabeprazole 20mg TID

rabeprazole is probably a better PPI than others.

you can continue bismuth and amoxicillin as it's very hard for HP to become resistant to them.
you can also have levofloxacin if you can get hold of it.

so

Rabeprazole 20mg TID
bismuth 240mg QID
amoxicillin 1000mg TID
levofloxacin 250mg BID

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