Helicobacter Forums

I have been suffering miserably from H. pylori for the last eight years. I have tried two treatment regimens in the past which failed to eradicate the infection. Specifically, 1) amoxicillin bid, clarithromycin bid and omeprazole bid and 2) minocycline bid, metronidazole bid, bismuth citrate qid and omeprazole bid. I had an antibiogram/microbial sensitivity test performed in 2007 after my last treatment failure and the results were the following: amoxicillin MIC=0,064, metronidazole MIC=>256, tetracycline MIC=0,047, clarithromycin MIC=1,5 and levofloxacin MIC=8. My gastroenterologist suggested that based on the sensitivity test results that I try amoxicillin bid, doxycycline bid with pantoprazole bid for ten days. The gastroenterologist who performed my endoscopy suggested that I try amoxicillin bid, rifampicin bid with pantoprazole for ten days. As a pharmacist I am aware that rifampicin is a strong antibiotic with more side effects that the other antibiotics, and that amoxicillin is not usually given concomittantly with tetracycline due to antagonistic microbicidal action. Could you please recommend the best possible treatment for my situation with the least possible side effects which will garrantee at least a 85%-90% eradication rate? Anxiously waiting for your professional opinion and answer to my dilemma. Thank you for taking the time to read this message. Joanna

Hi Joanna,
Please read the article linked at the end of my post.
Your options are limited however I suggest: maximise the dose of PPI, reuse amoxicillin (those old rules about interference between antibiotics are not especially relevant to Hp), consider bismuth/tetracycline/furazolidone/amoxicillin/PPI combinations. Suggestions are in the article. Our team have a new publication in preparation but we do not have any new antibiotics. However, the suggestions in the article I mention are still valid. Start studying!