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 at Marshall.centre(at)gmail(dot)com. In the subject, please use "Help needed for www.helico.com"

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?

If you are confirmed with H. pylori, in your convenient time, please help us with the symptoms survey that you are experiencing.
Symptoms survey
(contributed by frostyfeet)


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 Marshall.centre(at)gmail(dot)com。标题请用 "Help needed for www.helico.com"
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?

Upcoming H.Pylori treatment #7 - question on serum ferritin and sensitivity testing

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

Moderators: Toni, barjammar

ankiwo72
Posts: 73
Joined: Fri May 17, 2019 2:45 am

Re: Upcoming H.Pylori treatment #7 - question on serum ferritin and sensitivity testing

Post by ankiwo72 »

chetanvenki wrote:
Mon Sep 09, 2019 9:20 pm

What does this sensitivity numbers mean, please eloberate on how much dosage of antibiotics would be susceptible with these numbers. I am due to get my susceptibility test result this week.
My understanding is that those numbers are the minimum amount of each antibiotic in micrograms the bacteria was susceptible to. In some cases the amount was too high to be considered an effective treatment option. Maybe the moderators can explain better?

Helico_expert
Site Admin
Posts: 3770
Joined: Wed Mar 02, 2011 7:20 am

Re: Upcoming H.Pylori treatment #7 - question on serum ferritin and sensitivity testing

Post by Helico_expert »

Minimum Inhibition Concentration (or MIC) is the right term for antibiotic resistance determination.

according to the EUCAST guideline.
Quinolones MIC is 1 mg/L <- eg. ciprofloxacin
Tetracyclines MIC is 1 mg/L
Metronidazole MIC is 8 mg/L
Rifampicin MIC is 1 mg/L

according to the CLSI guideline.
Macrolides MIC is 1 mg/L <- eg. Clarithromycin

Although Amoxicillin MIC is set to be 0.125 mg/L, we think it should be 1 mg/L

If your H. pylori strain has a tolerance of these antibiotics greater than the listed MIC, then it is considered as resistant strain.
However, factors that may affect the MIC include
1. the methods of exposure of the antibiotics to the microorganism;
2. the brand (or purity) of the antibiotics; and
3. the technician handling the results.

ankiwo72
Posts: 73
Joined: Fri May 17, 2019 2:45 am

Re: Upcoming H.Pylori treatment #7 - question on serum ferritin and sensitivity testing

Post by ankiwo72 »

My last test result just came in and result showed (as moderator predicted) the last treatment failed. I think I miscounted treatments and that was actually the 6th treatment (not 7th).

I am scheduled for endoscopy/colonoscopy on Tuesday next week. I have requested blood tests (CBC and iron panel) and abx susceptibility testing again.

Is there anything else I should ask the doctor to do? Is testing the bacteria for CagA or VacA helpful in any way to determine virulence/pathogenicity? What would the name of the test be called for that and would this be at all useful for the doctor to help guide treatment?

Thank you!

Dignity
Posts: 1
Joined: Sat Nov 23, 2019 5:27 am

Re: Upcoming H.Pylori treatment #7 - question on serum ferritin and sensitivity testing

Post by Dignity »

I was tested H P but I have been taking lansoprazole capsule, Tinidazole and clarithromycin and am still feeling the same way. Pls what can I do

Helico_expert
Site Admin
Posts: 3770
Joined: Wed Mar 02, 2011 7:20 am

Re: Upcoming H.Pylori treatment #7 - question on serum ferritin and sensitivity testing

Post by Helico_expert »

I assumed you meant you were tested positive with UBT

then you were prescribed lansoprazole, tinidazole, and clarithromycin

Then you completed the 14 days treatment and your symptoms are still there.

In that case, you need to repeat your breath test in one month time.

Meanwhile, stop taking lansoprazole. you can take ranitidine until the night before breath test. We shall continue this discussion then.

ankiwo72
Posts: 73
Joined: Fri May 17, 2019 2:45 am

Re: Upcoming H.Pylori treatment #7 - question on serum ferritin and sensitivity testing

Post by ankiwo72 »

ankiwo72 wrote:
Thu Nov 21, 2019 11:50 pm
My last test result just came in and result showed (as moderator predicted) the last treatment failed. I think I miscounted treatments and that was actually the 6th treatment (not 7th).

I am scheduled for endoscopy/colonoscopy on Tuesday next week. I have requested blood tests (CBC and iron panel) and abx susceptibility testing again.

Is there anything else I should ask the doctor to do? Is testing the bacteria for CagA or VacA helpful in any way to determine virulence/pathogenicity? What would the name of the test be called for that and would this be at all useful for the doctor to help guide treatment?

Thank you!
Hi Moderator,

I am hoping you can respond to my question too. I just got result back from breath test and still positive. Last treatment was 30 days amoxicillin 3000mg/day plus 20mg omeprazole 3x/day (we had previous discussions on this), but that is not important now. If my endoscopy shows no progression to atrophy or metaplasia I need to take a break from antibiotics as they are wreaking havoc on my body, and also will get blood test to see if I have devolved to full-blown anemia.

Helico_expert
Site Admin
Posts: 3770
Joined: Wed Mar 02, 2011 7:20 am

Re: Upcoming H.Pylori treatment #7 - question on serum ferritin and sensitivity testing

Post by Helico_expert »

hmm... seems like you have tried almost everything.
Amoxicillin
Metronidazole
Clarithromycin
Levofloxacin
Tetracycline
Rifabutin

the only one you have not tried is furazolidone.

You heard of Talicia?
perhaps you want to give that a try?
https://www.redhillbio.com/RedHill/Temp ... &IID=13236

alternatively, you can just buy the pills separately to save some money.
the combination of talicia is
omeprazole 150mg TID (alternative is to use rabeprazole 20mg TID, better)
amoxicillin 1g TID
rifabutin 150mg TID

it might work for you because it has large dose of PPI. you can probably boost this treatment with bismuth 220mg QID too.

blood test is not useful
cagA and vacA testing are also not useful
histology is good.
if the laboratory can do bacterial culture, that would be ideal.

ankiwo72
Posts: 73
Joined: Fri May 17, 2019 2:45 am

Re: Upcoming H.Pylori treatment #7 - question on serum ferritin and sensitivity testing

Post by ankiwo72 »

Helico_expert wrote:
Mon Nov 25, 2019 11:38 am
the only one you have not tried is furazolidone.
Unfortunately furazolidone is not available in USA. It is no longer FDA-approved due to cancer concerns so not available to prescription here: https://en.wikipedia.org/wiki/Furazolidone
"Since furazolidone is a nitrofuran antibiotic, its use in food animals is currently prohibited by the FDA under the Animal Medicinal Drug Use Clarification Act, 1994.[5]

Furazolidone is no longer available in the US."
Helico_expert wrote:
Mon Nov 25, 2019 11:38 am
You heard of Talicia?
perhaps you want to give that a try?
https://www.redhillbio.com/RedHill/Temp ... &IID=13236
Talicia is not available yet in the US but should be in the first quarter of 2020. But I already did 14-day rifabutin/amoxicillin/omeprazole combination (actually switched mid-treatment to pantaprazole) back in March and it failed so I'm not sure how it would work better next time. Plus each time I go on amoxicillin I have to go through desensitization procedure and my allergist is adamant I shouldn't go through that again, or at least not for a while. I have been through the procedure 3x in the past year for 3 different H. Pylori treatments to include amoxicillin and it is very hard on my system.
Helico_expert wrote:
Mon Nov 25, 2019 11:38 am
it might work for you because it has large dose of PPI. you can probably boost this treatment with bismuth 220mg QID too.
Every treatment over the past year has had PPI 20mg/3x day except for last treatment which was 40mg/3x day PPI with high dose amoxicillin 3000mg/day, still didn't work
Helico_expert wrote:
Mon Nov 25, 2019 11:38 am
blood test is not useful
cagA and vacA testing are also not useful
histology is good.
if the laboratory can do bacterial culture, that would be ideal.
Yes, we are going to do susceptibility testing again. The last sensitivity test showed most drugs were going to be ineffective except amoxicillin. After a few of those treatments I don't know if amoxicillin will even be as effective now.
Previously:
Amoxicillin: <=0.008
Ciprofloxacin: >2
Clarithroymycin: >0.5 Resistant
Metronidazole: 32
Tetracycline: 1

For past year over 4 separate blood tests, my ferritin has gone down and is now low at 10. My iron saturation is borderline low at 15. Strangely enough, my serum iron level is within normal range. I am constantly fatigued and things hurt all over my body.
My hemoglobin, hematrocrit, MCH levels have all been steadily decreasing, and my RDW level has been increasing and is now high at 16.1
I had read somewhere that high RDW with H. Pylori has some correlation to intestinal metaplasia. My last endoscopy only showed chronic gastritis due to H. Pylori. Do you have any information on that correlation? Is there any validity to it?
Last year I had numerous wacky blood test results: high gastrin, high Chronic Uriticaria index, very high CGA (without PPI use--leading my GP to think I had carcinoid which thankfully turned out not to be), very high N-methylhistamine levels. Not sure if these are related to H. Pylori infection.
I suppose the endoscopy result will answer my question, but the waiting on the results is going to be torture!
Please let me know if there is anything that stands out to you that might be related?
Thanks!

NoxArcana
Posts: 34
Joined: Thu Feb 07, 2019 12:05 am

Re: Upcoming H.Pylori treatment #7 - question on serum ferritin and sensitivity testing

Post by NoxArcana »

ankiwo72 wrote:
Tue Nov 26, 2019 12:30 am
For past year over 4 separate blood tests, my ferritin has gone down and is now low at 10. My iron saturation is borderline low at 15. Strangely enough, my serum iron level is within normal range. I am constantly fatigued and things hurt all over my body.
My hemoglobin, hematrocrit, MCH levels have all been steadily decreasing, and my RDW level has been increasing and is now high at 16.1!
I had problems with fatigue, my doctor thought in iron deficiency too, but told me to test vitamin b12 and folic acid, iron levels and b12 were normal, but folic acid was extremely low, did you tested folic acid before?

Helico_expert
Site Admin
Posts: 3770
Joined: Wed Mar 02, 2011 7:20 am

Re: Upcoming H.Pylori treatment #7 - question on serum ferritin and sensitivity testing

Post by Helico_expert »

Every treatment over the past year has had PPI 20mg/3x day except for last treatment which was 40mg/3x day PPI with high dose amoxicillin 3000mg/day, still didn't work
and which PPI was that? 20mg omeprazole is probably equal to 10mg of rabeprazole.

Ciprofloxacin: >2
Clarithroymycin: >0.5 Resistant
Metronidazole: 32
Tetracycline: 1
You've got the most resistant strain I have ever encountered.
But your Metronidazole resistance is not too bad. Have you tried Rabeprazole + Bismuth + Tetracycline + Metronidazole combination?

high RDW with H. Pylori has some correlation to intestinal metaplasia
i have not come across articles that state correlation between RDW and intestinal metaplasia. But I think if it is significant, it would be mentioned in the treatment consensus as a marker.

Post Reply

Return to “Diagnosis and Testing 检测与实验”