Quadruple therapy after 2 failed ones

[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]

A biofilm buster like NAC can help.

[eps123]

Is NAC to be taken with the therapy or a week before?

[eps123]

Anyone? Helico_expert?

[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]

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]

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]

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!