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H pylori resistance
Posted: Sat Nov 13, 2021 11:05 am
by Rashed9
Hello . I am 28 male I have h pylori from one year I did first treatment (pylera) on may. Then I retested but still positive by breath test , I did second treatment amoxicillin and Levlo for 14 day on August . After two month I did endoscope that showed chronic severe gastritis active and h pylori positive . I changed my doctor to gastro specialist had recommended endoscopy and culture . I did culture but unfortunately failed they said h pylori immunostaining nigative . In this case what can you do ? And what’s the best treatment for me ?
Re: H pylori resistance
Posted: Sun Nov 14, 2021 12:31 pm
by Rashed9
Any answer?
Re: H pylori resistance
Posted: Sun Nov 14, 2021 3:36 pm
by Helico_expert
I agree that antibiotic sensitivity test is the best way to go. But not every laboratory is good in culturing this bacteria.
So why didnt the doctor start metronidazole or clarithromycin as your first treatment?
I am a bit confused if you are still positive of H. pylori or not.
anyway, it's good to know that you can take amoxicillin. It's very hard for H. pylori to become resistant to it.
If you are still positive of H. pylori, you can take the following
Strong PPI, rabeprazole 20mg TID
Strong bismuth, 240mg QID
Strong amoxicillin 1g TID
and one more antibiotic that you have not tried. eg. rifabutin or furazolidone.
Re: H pylori resistance
Posted: Mon Nov 15, 2021 12:58 pm
by Rashed9
My doctor didn’t start treatment with clarithromycin because my country has resistance on it
So we started with ppi +pylera for ten days
After two month I retested by breath test but still positive
So we started amoxicillin and levlo treatment +ppi for 14 day
After one month we did endoscopy that showed by histology I still have h pylori and active gastritis
Then I changed my doctor to another that recommended sensitivity test for culture . We did it but the lab failed to culture hp
So I am still positive and have hp by endoscopy and histology report
Re: H pylori resistance
Posted: Tue Nov 16, 2021 2:00 am
by Rashed9
Helico_expert wrote: ↑Sun Nov 14, 2021 3:36 pm
I agree that antibiotic sensitivity test is the best way to go. But not every laboratory is good in culturing this bacteria.
So why didnt the doctor start metronidazole or clarithromycin as your first treatment?
I am a bit confused if you are still positive of H. pylori or not.
anyway, it's good to know that you can take amoxicillin. It's very hard for H. pylori to become resistant to it.
If you are still positive of H. pylori, you can take the following
Strong PPI, rabeprazole 20mg TID
Strong bismuth, 240mg QID
Strong amoxicillin 1g TID
and one more antibiotic that you have not tried. eg. rifabutin or furazolidone.
Any answer?
Re: H pylori resistance
Posted: Tue Nov 16, 2021 10:27 am
by Helico_expert
If you are still positive of H. pylori, you can take the following
Strong PPI, rabeprazole 20mg TID
Strong bismuth, 240mg QID
Strong amoxicillin 1g TID
and one more antibiotic that you have not tried. eg. rifabutin or furazolidone.
Re: H pylori resistance
Posted: Tue Nov 16, 2021 8:36 pm
by Rashed9
Helico_expert wrote: ↑Tue Nov 16, 2021 10:27 am
If you are still positive of H. pylori, you can take the following
Strong PPI, rabeprazole 20mg TID
Strong bismuth, 240mg QID
Strong amoxicillin 1g TID
and one more antibiotic that you have not tried. eg. rifabutin or furazolidone.
My doctor today give me
Nexium 40 twice
Rifabutin 150 twice
Amoxicillin 1g twice
Bismuth two tablets qid
For 10 days
Any comments for this treatment?
Re: H pylori resistance
Posted: Wed Nov 17, 2021 10:15 am
by Helico_expert
it's a good treatment. all the best to your treatment.
did your doctor explain to you the possible side effects of rifabutin?
your urine, sweat, saliva, tears MAY turn reddish orange color. which is normal. dont get panic.
Re: H pylori resistance
Posted: Wed Nov 17, 2021 6:59 pm
by Rashed9
Helico_expert wrote: ↑Wed Nov 17, 2021 10:15 am
it's a good treatment. all the best to your treatment.
did your doctor explain to you the possible side effects of rifabutin?
your urine, sweat, saliva, tears MAY turn reddish orange color. which is normal. dont get panic.
Thank you
Yes he explained to me and did blood test before starting the treatment to make sure my kidneys are okay
I started today my treatment for10 days but I am asking about the dose of pepto bismuth ?
I take 2 tablets 4 time a day . One tablet of it is 262 !! Is normal ? Or over dose ?
Re: H pylori resistance
Posted: Thu Nov 18, 2021 12:09 pm
by Helico_expert
it's fine. your stool may turn very black. it's normal.