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Quadruple therapy after 2 failed ones

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eps123
Posts: 6
Joined: Sat Jan 06, 2024 6:06 am

Quadruple therapy after 2 failed ones

Post by eps123 »

Hi, I'm from the UK. I started having issues last year, usually with occasional nausea after eating fatty or spicy food.
A few months after it got very bad when I was sick with all kinds of symptoms every day.

H pylori was detected in my stool test and the doctor prescribed 7 days of therapy:
amoxicillin 1000 mg, metronidazole 400 mg, omeprazole 20 mg (all twice a day)

After failing this I went on another one for 10 days:
amoxicillin 1000 mg, clarithromycin 500 mg, omeprazole 20 mg (all twice a day)

After failing the second one (came positive in the stool test) I'm planning to go for a 14 days quadruple therapy.
I have a few questions for Helico_expert regarding the therapy as I want to make sure I have done everything for it to be successful.

1. I want to go with Bismuth this time however here in the UK we only have access to Pepto Bismol.
How should I dose it? One 30 ml cup provided twice a day with antibiotics or should I take more?

2. A higher dose of PPI always gives better results so omeprazole 20 mg twice a day that I used in 2 previous therapies is high enough or should I take something else?

3. Which 2 antibiotics should I use in this therapy, shall I use amoxicillin 1000 mg again or 2 completely different antibiotics and if so which ones?

4. Is there anything else I can use to support the therapy to increase the chances of its success like some biofilm disruptor, probiotics, mastic gum or any dietary tip?

I would be very grateful for any help.
saltysnack
Posts: 3
Joined: Mon Jan 08, 2024 5:12 am

Re: Quadruple therapy after 2 failed ones

Post by saltysnack »

A biofilm buster like NAC can help.
eps123
Posts: 6
Joined: Sat Jan 06, 2024 6:06 am

Re: Quadruple therapy after 2 failed ones

Post by eps123 »

Is NAC to be taken with the therapy or a week before?
eps123
Posts: 6
Joined: Sat Jan 06, 2024 6:06 am

Re: Quadruple therapy after 2 failed ones

Post by eps123 »

Anyone? Helico_expert?
Filiz-isabela-ziya
Posts: 5
Joined: Sat Feb 10, 2024 7:07 am

Re: Quadruple therapy after 2 failed ones

Post by Filiz-isabela-ziya »

Please check out my very detailed quad therapy that worked for me and my son. It’s Under Filiz quad treatment.
eps123
Posts: 6
Joined: Sat Jan 06, 2024 6:06 am

Re: Quadruple therapy after 2 failed ones

Post by eps123 »

Filiz-isabela-ziya wrote: Sat Feb 10, 2024 10:48 pm Please check out my very detailed quad therapy that worked for me and my son. It’s Under Filiz quad treatment.
Thank you for your help Isabela.

My doctor prescribed me quadruple 14 days therapy with PPI and 3 antibiotics: metronidazole, levofloxacin and amoxicillin but I have already ordered pepto bismol. Can I add pepto bismol to the stack? That would make it quintuple therapy.
Helico_expert
Site Admin
Posts: 4501
Joined: Wed Mar 02, 2011 7:20 am

Re: Quadruple therapy after 2 failed ones

Post by Helico_expert »

Interesting that your post didnt show up until today!

I hope it's not too late. It's ok to take pepto bismol for the bismuth. So how did you go with the quadruple treatment? Which other antibiotics did you take?
Filiz-isabela-ziya
Posts: 5
Joined: Sat Feb 10, 2024 7:07 am

Re: Quadruple therapy after 2 failed ones

Post by Filiz-isabela-ziya »

You need to double check first with your doctor if it’s OK to add the Pepto-Bismol. The only reason I used that quad therapy was because my son and I are allergic to penicillin. You also need to make sure that the Pepto-Bismol does not interact with any of the antibiotics you are taking. The Pepto-Bismol has been tested With the antibiotics we tried so just make sure that there are no contradictions. Good luck! :)
eps123
Posts: 6
Joined: Sat Jan 06, 2024 6:06 am

Re: Quadruple therapy after 2 failed ones

Post by eps123 »

Helico_expert wrote: Fri Apr 19, 2024 9:04 am Interesting that your post didnt show up until today!

I hope it's not too late. It's ok to take pepto bismol for the bismuth. So how did you go with the quadruple treatment? Which other antibiotics did you take?
I have done the stack below for 14 days, I also have taken any supplement that could potentially increase the chance of eradication.
I still have occasional nausea and stomach burning but I suppose this could be my generalised atrophic gastritis that I was diagnosed on my recent gastroscopy. I haven't done the stool test yet, I still have to wait at least 3 weeks. I don't know what will I do if it comes positive because it seems like I have tried everything I could.

Pepto Bismol 30ml BID
Rabeprazole 20mg TID (every 8 hours)
Metronidazole 400mg TID (every 8 hours)
Tetracycline 500mg QID (every 6 hours)


- NAC (600 mg twice per day) for 10 days before the therapy. I didn't want it to interfere with tetracycline
- Pyloguard (one capsule per day in a drink)
- Manuka honey MGO 400 (one teaspoon per day)
- mastic gum (chewing twice per day) preferably on empty stomach
- turmeric with bioperine (1 tab per day)
- turmeric with omega3 (1 tab per day)
- probiotic Pro live cultures 5 (2 capsules per day)
- vitamin C (1000 mg twice per day)
- Cranmed (1 capsule per day)
- multi vitamin (1 tab per day)
- vitamin D (5000 uq per day)
- Vitamin K2

No Dairy (calcium), no alcohol, no sour food, loads of water and organic cranberry juice
kosa
Posts: 9
Joined: Tue May 14, 2024 8:12 pm

Re: Quadruple therapy after 2 failed ones

Post by kosa »

Hi @eps_123, how are you now ?
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