Quadruple therapy after 2 failed ones
Posted: Sun Jan 07, 2024 5:47 am
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.
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.