3rd Treatment, Help, Support and Encouragement needed

[Simi_25]

Hi Helico_Expert

Need your help!

I have had H pylori since being infected in March 2024 during my trip to India and I am really sick, barely functioning
I live in the US

2 treatments have failed,
The first was triple therapy in June PPI omeprazole, Amox, and clarithromycin 14 days

2nd was Quad therapy in Dec, PPI Rabeprazole, Bismuth, Flagyl and Tetracycline could only make it 9 days since the Flagyl was causing extreme vomiting, loss of brain function, slurred speech, and difficulty walking.
felt good for a week and all symptoms came back on day 8 post-treatment

Now in Jan 2025, I'm still H Pylori positive

I need to eradicate H Pylori ASAP, I am barely functioning
For the 3rd treatment, I want to try Talicia for 14 days, with additional PPI Voquezna 20mg twice a day and Bismuth (2 liquid caps) 4 times a day

Is this a good stack? To my knowledge, i have never been on Rifabutin ever in my life, i see that it is rarely prescribed, only in special cases for TB

What success rates have you seen with Rifabutin & high amoxicillin on 3rd course of treatment?

[Helico_expert]

I am sorry to hear about your difficulties. Before you start on rifabutin, perhaps you could first check with your doctor about the potential for using levofloxacin instead.

One of the most crucial elements for significantly increasing the success rate of any H. pylori treatment is strongly suppressing the secretion of stomach acid. Vonoprazan is an excellent option for this, provided your doctor is able to access it for you. Some research has demonstrated that just the combination of vonoprazan and amoxicillin alone can achieve an impressive cure rate of around 80%.

To make the regimen even more robust and increase your chances of complete eradication, you could discuss adding both levofloxacin and Pepto Bismol (bismuth subsalicylate) to the combination.