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欧洲幽门螺杆菌治疗共识 5
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3rd treament??? NEED SOME HELP

The cure of Hp usually requires antibiotics. Other things have been tried and have a weaker effect.

Moderator: barjammar

lolita1970
Posts: 6
Joined: Tue Mar 29, 2011 11:21 pm

3rd treament??? NEED SOME HELP

Post by lolita1970 »

Hi everybody

Live in USA, from the last 5 years I have been suffering excess of gas in my stomach, last year become worst, every thing that I eat produce me "to break wind", water, grapes,anything that i eat.
On January the doctor diagnostic that i have Helicobacter Pylori, then gave me Metronidazol 500 mg (2 tablets daily) Amoxicillin 500 mg (4 tablets daily) and Omeprazole 20mg for 7 days.
On February repeat the test and bacteria is still present, now send me Clarithromycin 500 mg (2 tablets daily) Amoxicillin 500 mg (4 tablets daily) and Omeprazole 20mg for 7 days.

After that, nothing happens and told me that take Prevpac, that is a good treament for this, before send me to a gastroenterologist, but this medicine is very expensive in USA, and I would like to know what do you think about that, if is it a good idea or take again the second treament but for 14 days that was the other option that the doctor told me.
The endoscopy is more expensive that a prevpac, then, no easy to choose, any help ???

(My English is not good,thanks)
Helico_expert
Site Admin
Posts: 4513
Joined: Wed Mar 02, 2011 7:20 am

Re: 3rd treament??? NEED SOME HELP

Post by Helico_expert »

hi, have you done a breath test after your 2nd treatment?
lolita1970
Posts: 6
Joined: Tue Mar 29, 2011 11:21 pm

Re: 3rd treament??? NEED SOME HELP

Post by lolita1970 »

yes, i had a second test also and still was positive.
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barjammar
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Re: 3rd treament??? NEED SOME HELP

Post by barjammar »

It is expensive to do, but the next line of treatment (PPI - AMOX - CIPRO - RIFABUTIN) is listed in the article which appears on the bottom of my signature link. Cure rate about at least 80% - after that it is really tough and you should start saving up for a visit to an expert in Hp treatment. 8-)
Check the link below for information on hard-to-treat cases. Then search the forums for questions and answers similar to yours.
docs/200808%20stenstrom%20Hp%20Treatment.pdf
lolita1970
Posts: 6
Joined: Tue Mar 29, 2011 11:21 pm

Re: 3rd treament??? NEED SOME HELP

Post by lolita1970 »

Thanks, finally I am taking Prevpac for 14 days, that is 4 capsules every 12 hours, 1 prevacid 30mg, 1 biaxin 500mg and 2 amozicillin 500 mg, when i finish and come back to doctor, let all know about that.
Thanks a lot.
rifle_li
Posts: 48
Joined: Sun Mar 27, 2011 10:30 pm

Re: 3rd treament??? NEED SOME HELP

Post by rifle_li »

Hi,I am as same as you. Two fails of treatment. I searched "Prevpac" on the NET, it is basically as same as your second treatment. I choose a third line therapy on helico.com. PPI standard dose bd/bismuth subcitrate 120 mg qid/furazolidone 200 mg bd/tetracycline 500 mg qid. And I plan to take my medicines from tomorrow. When I finish I will let all know about the end. Here's good luck to you!
lolita1970
Posts: 6
Joined: Tue Mar 29, 2011 11:21 pm

Re: 3rd treament??? NEED SOME HELP

Post by lolita1970 »

The same to you, thanks
euphoria
Posts: 6
Joined: Fri Jul 16, 2010 8:47 am

Re: 3rd treament??? NEED SOME HELP

Post by euphoria »

barjammar wrote:It is expensive to do, but the next line of treatment (PPI - AMOX - CIPRO - RIFABUTIN) is listed in the article which appears on the bottom of my signature link. Cure rate about at least 80% - after that it is really tough and you should start saving up for a visit to an expert in Hp treatment. 8-)

Hmm, how about using levofloxacin instead of ciprofloxacin, would that have any advantages? Side-effect wise which one is worse levo or cipro?

For example, there is a review on the use of levofloxacin for eradication of H. Pylori: _http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2036.2006.02737.x/pdf

However, some researchers questioned the efficiency of levofloxacin-based rescue therapy, so there was a heated debate going on, unfortunately as I'm not a doctor I don't understand their arguments so I can't have an opinion on this:

1.) _http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2036.2006.02857.x/pdf
2.) _http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2036.2006.02866.x/pdf

Well, I haven't read those papers thoroughly yet, as I just happened to find them. I'm myself on a third-liner, doctors can't really help me as 2 years have passed and I'm more or less still convincing them that it ain't about stress n' coffee. So I'm trying to find a suitable third line treatment myself by using Internet. Based upon the information from the links above, I am now considering the levofloxacin alternative, that is: levofloxacin (500 mg two times a day), amoxicillin (1 g two times a day), and omeprazole (20 mg or more 2 times a day) for 10 days and maybe pray :roll: . However, I have doubts about the efficiency of amoxicillin as I pointed out in the thread I just started: viewtopic.php?f=33&t=201606 Why? Well, I don't know if the presence of beta-lactamase inhibitor is essential to the efficiency of amoxicillin pills or not. Maybe I should avoid amoxicillin compleatly and use bismuth instead.

EDIT: There is evidence that bismuth does not impair the bioavailability of ciprofloxacin _http://www.ncbi.nlm.nih.gov/pmc/articles/PMC284708/ while it does so on for example tetracycline-like drugs: _http://jama.ama-assn.org/content/247/16/2266.abstract so maybe one should use the traditional bismuth triple therapy but replace tetracycline with levofloxacin? Which has more H. Pylori resistance cipro/levo or tetra/doxy?

I also noticed that eating raw, fresh garlic helps with the symptoms, try it if you want, it might help you! By the way, does anyone know if eating 2-3 cloves of garlic everyday for years is a dangerous practice? :oops:

Note: I had to use _ before a link otherwise I couldn't make the post... :mrgreen:
rifle_li
Posts: 48
Joined: Sun Mar 27, 2011 10:30 pm

Re: 3rd treament??? NEED SOME HELP

Post by rifle_li »

As I know, eating 2-3 cloves of garlic everyday for years is safe for you. Many people in China used to eat raw garlic everyday and nothing bad happened to them.
lolita1970
Posts: 6
Joined: Tue Mar 29, 2011 11:21 pm

Re: 3rd treament??? NEED SOME HELP

Post by lolita1970 »

Finally third treatment worked for me, feel ok without problems.
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