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Four quad therapy failed and allergic to penicillin

After first line treatment, various "second line" treatments can be used. The policy for H.pylori is: Make sure the infection is real (breath test for follow-up). Always give a high dose of PPI (acid blocker) when using amoxicillin. In the second treatment, give a different drug in place of clarithromycin.

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Deedee
Posts: 5
Joined: Mon Nov 02, 2020 3:32 pm

Four quad therapy failed and allergic to penicillin

Post by Deedee »

Hi
I’m seeing a gastroenterologist who never had a patient that failed after quad therapy and antibiotic sensitivity testing. I’m born in China but grew up in Australia.

I tested positive to HP. I’m allergic to penicillin. My GP prescribe me nexium, flagl and klacid. I had allergic reaction to the medication where I had red spots. I finished the course and tested positive to HP.

Then I was referred to specialist and had endoscopy and antibiotic sensitivity testing for HP was successful. I was prescribed quadruple therapy with bismuth - nexium, ciprofloxacin, tetracycline and denol. The tetracycline and bismuth I got from compounding pharmacy my specialist referred me to. I took for 14 days and felt better. After a month my HP symptom came back of bloating and stomach pain and sulphur taste. I tested positive after 6 weeks.

What would I do now as all my specialist patients have been cured with quadruple therapy and I’m allergic to penicillin so I can’t take amocillin.

Deedee
Posts: 5
Joined: Mon Nov 02, 2020 3:32 pm

Re: Four quad therapy failed and allergic to penicillin

Post by Deedee »

I took the below for 14 days and I followed the instructions
1. nexium 40mg - twice a day
2. Ciprofloxacin 500mg - twice a day
3. Tetracycline 500mg - four times a day
4. Bismuth 120mg - four times a day

TinaSF
Posts: 21
Joined: Sun Nov 01, 2020 1:43 pm

Re: Four quad therapy failed and allergic to penicillin

Post by TinaSF »

Try using a new toothbrush throughout treatment. Or if you use a night guard for your mouth, disinfect it with alcohol after every use during treatment.
I read articles that you can reinfect yourself by reusing contaminated products and placing them in your mouth. Stay on a probiotic and keep a clean, bland diet that helps to inhibit bacterial growth during and after treatment. Skip processed sugars, eat lots of vegetables and fruit, and drink green tea with manuka honey. Holistic treatment can't eradicate h pylori but it might help or boost the effectiveness of your treatment.
If you resume a quadruple therapy with tetracycline, I read that its best to space bismuth at least two hours away from Tetracycline because it interferes with the absorption of Tetracycline. I hope your new treatment works and will be the last one.
Make sure you retest with stool sample as its the most accurate. Blood sample only shows antibodies to h pylori but does not indicate current infection, only prior exposure or infection.

Helico_expert
Site Admin
Posts: 4466
Joined: Wed Mar 02, 2011 7:20 am

Re: Four quad therapy failed and allergic to penicillin

Post by Helico_expert »

what else did your antibiotic sensitivity report say about your HP strain?

perhaps you can try
1. Rabeprazole 20mg TID
2. Denol 240mg QID
3. Tetracycline 500mg QID
4. Metronidazole 400mg TID

There are reports saying that when metronidazole is used together with tetracycline, the resistance can be overcome.
Although you had used Tetracycline before, it is very hard for H. pylori to become resistance to.

Perhaps you can check with your doctor about trying this combination next.

Deedee
Posts: 5
Joined: Mon Nov 02, 2020 3:32 pm

Re: Four quad therapy failed and allergic to penicillin

Post by Deedee »

Thanks heli expert. Do you think I could have got reinfected by wearing a retainer at night?

I didn’t wear it during treatment. I wore it few weeks after treatment. I assumed even if there was hp bacteria, it was exposed to air for weeks and wouldn’t survive.

Deedee
Posts: 5
Joined: Mon Nov 02, 2020 3:32 pm

Re: Four quad therapy failed and allergic to penicillin

Post by Deedee »

Is it worth I get test done to see if I’m allergic to penicillin. I had the test done as a kid which was positive. I did have allergic reaction when I took triple treatment of flagl, ppi and kacid

Deedee
Posts: 5
Joined: Mon Nov 02, 2020 3:32 pm

Re: Four quad therapy failed and allergic to penicillin

Post by Deedee »

If I have resistence to metrozadole, should I still take the combo you suggested?

Helico_expert
Site Admin
Posts: 4466
Joined: Wed Mar 02, 2011 7:20 am

Re: Four quad therapy failed and allergic to penicillin

Post by Helico_expert »

Helicobacter doesnt survive very well outside human body. If you retainer is left dry or cleaned with soap, it's most probably alright.

It's a good idea to get penicillin test again to see if you are still allergic to it. If you are going for that test, perhaps should also include cephalosporin. cephalosporin acts like penicillin and less people are allergic to it. Sometimes, doctor replace penicillin with cephalosporin.

if your HP is resistant to metronidazole, then you can still take it together with tetracycline.

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