Helicobacter Forums

Hello, and thank you to those who have contributed so graciously to this informative forum. I expect that I will have to begin antibiotic treatment for H Pylori. I have concerns about any negative side effects and want to use the most effective treatment with the and least side effects. I am an active middle-aged male and take no medications. I have a couple of questions:

1. For a first-time treatment of H Pylori, is there a minimal treatment for H.Pylori that doesn't require several antibiotics?

2. For a first-time treatment of H Pylori, is Sequential therapy the better choice compared to triple or quadruple therapy?


Thank You So Much!

HI,

from what procedural test you have been diagnosed for HP ?

The minimum required to cure Hp is a triple therapy which is 2 antibiotics + 1 acide reducer. Quadruple therapy has 3 antibiotics which means it can be more effective but also more side effects. Then again, everyone is different and you might not experience any side effect at all. Usually the triple therapy is quite successful. Sequencial therapy is a quadruple therapy where one antibiotic is replaced by another one during the second week of the treatment. It is a successful treatment but not usually prescribed as a first treatment. I think the only reason your treatment might fail would be because of antibiotic resistance. The only way to know is to culture the bacteria from biopsy (endoscopy). I don't think it is necessary but it is an option if you want to make sure you have the right treatment straight away.
Hope this help.

I have read that the triple therapy of amoxicillin, Clarithromycin/metronidazole and PPI have an 80% effectiveness. Are there more effective treatments?

Thank You

amoxicillin, clarithromycin/metronidazole, and PPI is used as the first line. Because the guideline suggested that we should always use the most common antibiotics first. nevertheless if you had tried triple therapy and failed, you can have a look at our recent publication.

http://onlinelibrary.wiley.com/doi/10.1 ... 8A0.d04t03

and the supportive document where you’ll find the summary of the treatment plan
http://onlinelibrary.wiley.com/store/10 ... 4ca1d1eb37

Thank you. Are the clarithromycin and metronidazole both used in triple therapy or only one of these antibiotics? Is there a treatment summary that you recommend for the triple therapy of amoxicillin, clarithromycin/metronidazole, and PPI? Again, I don't take any medications am active and a healthy weight.

Thanks!

the combination is either
1) PPI + amox + clari
2) PPI + amox + metro
3) PPI + clari + metro

the 3rd option is for patients who are allergic to penicillin.

There are so many brands of the above combinations. So you'll have to find out what's available in your country.

More Concerns About Triple Therapy:

A few items that I have read are suggesting that triple therapy has a low cure rate of 50-75% in the US. A Johns Hopkins Medical website suggests that the Clarithromycin resistance rate ranges from 11-24% in US populations (where I am). Metronidazole resistance rates may be as high as 37% in US populations. These resistnace rates appear to be responsible for a decrease in the effectiveness of triple therapies. Should I require resistance testing before using these antibiotics? I don't want to endure the antibiotic course and have it fail, I want the therapy to work the first time........... Should I request resistance testing for Clarithromycin?

http://www.hopkinsguides.com/hopkins/ub ... er_Disease

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1994350/


Thank You!

In our clinic, we collect biopsy from patients, grow the bacteria in laboratory, do antibiotic test to find out which antibiotic works, then prescribe the most effective combination. we have a success rate of >90% in first treatment. perhaps you can request your specialist to do the same. it's more costly, but that is the only way to make sure it works straight away.

I will request this from my health care provider. What antibiotics should they check for resistance before determining a therapy?

Thank you!