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Is Erythromycin the right antibiotics for H. Pylori?

The most popular treatments consist of two antibiotics (one of which is usually clarithromycin) plus a strong acid blocker such as omeprazole (PriLosec, Nexium, Somac, Zoton, etc.). Treatment is for 7-10 days. Cure rate is about 85%

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WonderBoy123
Posts: 2
Joined: Mon Nov 21, 2022 5:16 am

Is Erythromycin the right antibiotics for H. Pylori?

Post by WonderBoy123 »

I self-diagnosed through an OTC stool antigen test last week, and was prescribed the following by my GP (for 14 days):

Amoxycillin 500mg 3 times a day
Erythromycin 250mg 3 times a day
Omeprazole 20mg twice a day
Cimetidine 200mg 3 times a day

I started my treatment last Monday, and the swelling / burning of my stomach and intestines went down immediately overnight. I am half way through the treatment now, and started to have a bit of abdominal pain here and there which makes me a bit paranoid that my treatment isn't working.

After some online research, I found some articles stating that erythromycin is not an effective microlide for H. pylori, and it seems most treatments uses clarithromycin. I've also read that different regions have differing types of antibiotics resistance, could this be the reason why I was prescribed erythromycin rather than the usual clarithromycin? (I'm based in Hong Kong)

I would love for an opinion on whether this is an adequate treatment, or if the dosage is too low (saw some treatments prescribing 750mg - 1g amoxycillin) / the wrong antibiotics was prescribed. Thanks in advance!

Side question: If I were to do the stool test again to confirm eradication, how long after my treatment should I do it? (My first one actually tested negative due to the PPIs (for 3 days) my GP initially put me on. I retested 2 days after the PPIs and was positive.)
Last edited by WonderBoy123 on Mon Nov 21, 2022 5:12 pm, edited 1 time in total.

Tamsojo
Posts: 4
Joined: Sun Aug 21, 2022 5:18 am

Re: Is Erythromycin the right antibiotics for H. Pylori?

Post by Tamsojo »

Hi - I have had similar treatment for HP but I had Clarithromycin (which is a member of the macrolide/erythromycin family), amoxcillin and pantoprazole. (I'm in NZ). I thought I was getting better but then started with the 'gnawing' pain again - retested faecal antigen test 3 mths post treatment, positive result. Which really disappointed me as I had done everything right re meds, diet, no alcohol etc etc. So now this week I'm starting quadruple therapy of omeprazole, tetracycline, bismuth and metronidazole. Not looking forward to it at all, but hopefully will manage to get through with not too many side effects (I was fine on the triple therapy - apart from the metallic taste in mouth). It's such a nasty disease. I hope you start to feel better soon. edited: I should have said, I had had many macrolides when younger so I think I was probably resistant to the clarithromycin. Cheers

WonderBoy123
Posts: 2
Joined: Mon Nov 21, 2022 5:16 am

Re: Is Erythromycin the right antibiotics for H. Pylori?

Post by WonderBoy123 »

Tamsojo wrote:
Mon Nov 21, 2022 2:28 pm
Hi - I have had similar treatment for HP but I had Clarithromycin (which is a member of the macrolide/erythromycin family), amoxcillin and pantoprazole. (I'm in NZ). I thought I was getting better but then started with the 'gnawing' pain again - retested faecal antigen test 3 mths post treatment, positive result. Which really disappointed me as I had done everything right re meds, diet, no alcohol etc etc. So now this week I'm starting quadruple therapy of omeprazole, tetracycline, bismuth and metronidazole. Not looking forward to it at all, but hopefully will manage to get through with not too many side effects (I was fine on the triple therapy - apart from the metallic taste in mouth). It's such a nasty disease. I hope you start to feel better soon. edited: I should have said, I had had many macrolides when younger so I think I was probably resistant to the clarithromycin. Cheers
Hey! Oh no, that is exactly what I'm worried about. I'm half way through my treatment, and yesterday started having a slight bit of pain in my stomach & intestines in the middle of the night (doesn't feel anywhere near as bad as before I was on antibiotics). It could just be the antibiotics and PPI being harsh on the stomach, maybe I'm just paranoid I don't know. May I ask how long after the treatment did you start getting the pains again? Or did your symptoms come back again in the middle of your treatment?

I have no clue what antibiotics I took when I was younger, but I can confidently say for the last 8 years I've only taken penicillin for recurrent tonsillitis. Hopefully that won't affect the effectiveness of amoxicillin. Since I've started my treatment I've been feeling so tired and weak, so I totally get what you mean, must be annoying having to do it all over again... Wish you all the best in your treatment and hope you can finally get rid of the bug this time!

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