Helicobacter Forums

No I have not taken rifabutin, levofloxacin, doxycycline or Nitazoxanide before.

Would the other drugs interact with rifabutin in anyway? Would it not boost the cure rate?

All these antibiotics come with some degree of damages to your liver and side effects. Let's not try the extreme while you can use the quadruple therapy i mentioned.

You are extremely helpful, I appreciate it very much.

I have gotten a second opinion from another doctor who has recommended the following, it turns out Rifabutin and Nitazoxanide are not available in the UK.

Rabeprazole 40mg
Levofloxacin 500mg
Tinidazole 500mg
Amoxicillin 1g
Bismuth 300mg

All of the above twice a day for 14 days, there is a strong study in the above regimen: https://www.gastrojournal.org/article/S ... X/abstract

Please can you advice on any changes?

Thank you once again Helico Expert

In the article you have just shared.. the two groups used quadruple therapy, that is PPI + Amox + Levo + tini.

The medications you listed consist of 5 drugs.
PPI + Bis + Amox + Levo + tini

I guess bismuth is not very harmful. so you can use it to give this treatment a boost.
It is very important that you have never taken levofloxacin, or ciprofloxacin or moxifloxacin or any other quinolones. They are all the same class.
similarly, tinidazole and metronidazole are the same class.

So the above treatment wont work if you have taken metronidazole or quinolones before.

lastly,
I assume you meant rabeprazole 40mg twice a day, as long as your doctor approves it. then it's ok. otherwise, it should be 20mg 3 times a day
you can increase Amoxicillin 1g to 3 times a day.
you can also increase bismuth 300mg to 3 times a day.

Hello Helico Expert,

I just realised that I have taken Metronidazole in my second treatment, what would be my next option considering I have not used Levofloxacin before. Maybe higher dose levofloxacin and amoxicillin and PPI 3 times a day for 10-14 days?

I have used: clarithromycin, tetracycline and metronidazole.

Please if you can advice I would be extremely grateful.

Thank you

In that case you can try PBAC

Rabeprazole 20mg three times a day
Bismuth 300mg three times a day
Amoxicillin 1g three times a day
levofloxacin 500mg two times a day

Please remember that you should always get a doctor to monitor your side effects.

Hello Helico Expert hope you are doing good.

I just had a question that was bothering me for a while, I hope you could answer it please.

If I undertake a h pylori culture, and it shows for example that my h pylori is sensitive to clarithromycin, would that mean I am able to take the drug again with a different approach? Or would the result be useless since I have already taken that drug in my 1st treatment?

Besides I know it’s difficult to culture H pylori even my doctor said it’s only about 50% successful in the UK.

Thank you for your support

Yes. if the lab is able to culture your HP and it showed that it is sensitive to Clarithromycin, then you are allowed to repeat the use of Clarithromycin even if you had it before.

That's why it is important to do this test.

It is well known that the HP is hard to culture. But if they have the right person, they can do it. Our lab has a culture success rate of over 90%. The labs that we trained also able to achieve similar results.

Dear Helico Expert,

I am so desperate now I really need help, h.pylori still detected in my stool after 4 treatments my stomach acid is so low I cannot eat absolutely anything literally nothing at all. I don’t even think I can survive this ordeal, I do not know what is going on.

With all this misery and pain I’m going through doctors and my GP think I’m crazy when I say I have extremely low stomach acid, they do not even believe me at all!! It feels like I’m the only one in the whole UK suffering with this.

Do you have a clinic I can travel to for treatment after lockdown is over? I will spend all my life savings if this is what it takes.

I have tried: clarithromycin, metronidazole, tetracycline, levofloxacin.

I don’t even know if furazolidone or rifabutin is even available in the UK (most likely it is not and if it is the stupid inexperienced doctors would not prescribe it) which means I will just die from hunger. I have no stomach acid at all.

Can you help in anyway please I don’t want to die in this way.

Thank you

so what antibiotics and dosage did you take in the last treatment?

you mentioned about the HP culture option, is it something that your specialist can offer?

during the treatment, do you feel better?