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欧洲幽门螺杆菌治疗共识 5

Previous Antibiotic Exposure?

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.

Moderator: barjammar

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Posts: 1
Joined: Wed Aug 23, 2023 9:45 am

Previous Antibiotic Exposure?

Post by Glorybee »

Hi there,
H.Pylori positive stool test on Sept 2022. And had 2 endoscopies since and also 2 lots of antibiotic treatment. And still testing positive.
Initial symptoms that alerted her GP to checking for H.Pylori - Chronic burping and pain in upper left quadrant, more uncomfortable feeling and nausea and weight loss.

Treatment and Results
Persistent H.pylori infection despite triple and quadruple therapies
- H.pylori stool antigen positive on Sept 22
- Completed 14 day course of triple therapy including Amoxicillin and Clarithromycin in November 2022
- Gastroscopy on Dec 22 reported mild gastritis
- Gastric body biopsies reported mild chronic gastritis
- H.pylori culture did not isolate H.pylori after 10 days
- H.pylori stool antigen positive on Feb 23
- Prescribed 14 day course of quadruple therapy including Amoxicillin, Tetracycline and Gastrodenol in March 2023
- H.pylori stool antigen positive on Jul 23
- Gastroscopy on Aug 2023 – reported mild gastritis in fundus
- Gastric body biopsies taken from the gastric body and gastric antrum were normal
- H.pylori culture did not isolate H.pylori after 10 days (specialist advised had taken 8 biopsies)
- H.pylori stool antigen positive on Aug 23

Compliance of the treatments – Triple therapy, took first dose and house came down with a stomach bug, tried to take second dose and doctor advised to wait a few weeks. Then took full dose with no problems including repeating the two missed doses. The Quadruple therapy 100% compliance on empty stomach.

Next steps:
Specialist has recommended treatment with a 14 day course of triple therapy including
Omeprazole 20mg twice daily, Amoxicillin 1g twice daily and Rifabutin 150mg twice daily.

Started with naturopath to see if this could aid helping eradicate when next course of antibiotics is taken. Have been taking the following since:
Herbal Formula of Coptis Chinensis, licorice, turmeric, ginger.

From starting the naturopath formula within 2 days her burping has stopped.

Just started taking blended Broccoli Sprouts in water also.

Could you please share opinion on following:

Antibiotics taken in past could this be impacting the success of eradication? Had a lengthy course of antibiotic Minocycline for inflammatory acne in 2002 and Macrolide antibiotic approx. 15 years ago could this impact the antibiotic treatment?

How many times should the eradication treatment with antibiotics be taken?

If antibiotics don’t eradicate what other option is there?

The H.Pylori did not show up in samples taken in the last endoscopy and they took 8 samples so how does this still test positive in the stools?

Is it wise to take Amoxicillin for a third time?

If it is resistant to Amoxicillin does that mean it would have become resistant to the other antibiotics that have been tried in the triple and quadruple therapy?

Are drug treatments in Australia available that are not in NZ?

Many thanks for your time.

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