7 daysTriple Therapy with Prevacid , flagyl and Amoxicillin

[Zamunda]

Hello,
Thank you for this forum.

Five months ago, my blood work showed HP infection and the doctor prescribed me HP_Pac for 7 days. However, I did not take it for I first wanted to try natural treatment.
When I made up my mind to try the antibiotics, I went back to my doctor again and asked him to renew my prescription. This time he said, Hp-Pac are no longer working well in Canada and he gave me a new 7 days prescription that consists of Prevacid (30mg), Flagyl (500 mg) and Amoxiclllin (1 g ) to be taken 2x a day. I could not find the 2015 Canadian consensus on HP treatment anywhere in the internet, but are these combinations common ? I don't seem to see it mentioned alongside the treatment combinations, neither is it listed in your HP treatment protocol . I read that Flagly has short half-life and it might not be enough to take it 2x a day. My doc does not hold much about adding Pepto Bismol, so he did not recommend it. Would you think It helps if I add it to the regimen and if the bacteria can develop resistance to the salt, incase I have to take the quadruple therapy that contains Bismuth ?? Any info is greatly appreciated. Thanks

PS: 2 years ago, I had taken two rounds of Amoxiclllin for dental infection. Would this create resistance problem with the stomach bug?

[sunshine37]

... H. pylori can never become resistant to pepto bismol. you can always use it in combination with other antibiotics.

I had this response to my post and thought it might help you, Zamunda.

[sunshine37]

...Blood test only tells you your history of infection. You could be exposed to H. pylori a long time ago but for whatever reason, you no H. pylori in your stomach. According to the guideline, you should only take antibiotic when proven of infection....

Zamunda, this taken from my post, "Blood Test positive, stool test negative-redo?." I thought this might help you, as well, as it looks like you are noting that you were diagnosed based solely on a blood test. To diagnose, you need to take a stool antigen test or a breath test, which will show whether or not you have an active infection.

[Zamunda]

Sunshine ,

Thank you for the information on Pepto Bismol . I will consider adding it .
I went for check up , because after eating raw tomato that was probably mixed with some rotten ones, I started having stomach complaints like bloating , pain , acid reflux etc . It is all mild , however . The blood test showed high counts of HP antigens as the doc put it . The doc said stool test was not necessary as my complaints were consistent with an active infection . Now , to make sure these bugs are gone , I decided to try the therapy. But when i saw him few months later to update the prescription , he changed it ( replaced claritomycin by flagyl ) and these new combinations made me a bit wary as I don't seem to find any good info that they work better. Infact , the HP resistance rate to metrozinadole is quite high in Canada, as the medical literature shows . He said , he recently attended a conference on HP and the treatment recommendation were updated . I asked my pharmacy if there were new guidelines , but they said they were not aware of any and Hp-Pac was still the first line therapy . They thought , the doc may have prescribed flagyl , because it is cheaper than Biaxin .But , I never asked the doc to prescribe cheaper drugs . I do not have any antibiotic related allergy. For that reason , I hoped to find some advice here , and hopefully someone replies , before I seek a different doc to verify .

[addseo2015]

It's good forum for health.
Glad to see the useful info.

[sunshine37]

Hi Zamunda:

Since changing to a special diet for GERD (acid reflux), I have not had as much trouble. It is basically 6 small meals per day. No tomatos, coffee, tea, no citrus, no fried fooods, avoid red meat as it is fatty, avoid white bread and potato. Example diet: 1/4 cup cooked oats with 1 cup strawberry for breakfast, yoghurt (2/4 cup) with 1 cup cucumber snack, 2 pieces of wheat bread, turkey (I eat an avacado, as i am veg), 1 cup blue berries, 1 cup of veg lunch, 1 string cheese, 6 whole grain crackers snack, one piece of fish, 1/2 cup cooked rice, 1 cup of mixed veg dinner. Hope this helps. I have been alternatiing the fruits and veg and that seems to be working.

I was diagnosed based on a blood test high antibody rate (2.2 when minimum was 1.1, for probably infection, per doctor) as well as my symptoms, which were pretty bad at the time. I still think it is better to get a second test (breath test is the best, but stool is also okay) to make sure there is an active infection prior to taking antibiotics. Maybe the doctor will let you get one? (At least for peace of mind). Mine did agree, finally, as I was so concerned. Just don't take any proton pump inhibitors (like Nexium) for at least 7 (14 days better so that the bacteria can build up). I will post a helpful link that Helico-Expert posted that will give you more details of what to avoid prior to the tests.

Yes, the pepto sounds good... I will also take it when I take my antibiotics. (I suspect that I have an active infection, but just want the test to back this up).

[sunshine37]

http://www.helico.com/PYtest_guide_2013.pdf Here is the link.

[sunshine37]

P.S. The main site mentions that the conventional treatment is . http://helicobacterpylori.net.au/helico ... reatments/ (HP-Pac Common Name: lansoprazole - clarithromcyin - amoxicillin) .... lansoprazole is the active ingredient in Prevacid. and, flagyl is the other name for Metronidazole, which is a substitute for Amoxcillin for those who are allergic to pencillins. Your doctor might be right, as Biaxin (Clarithromycin) is showing to be problem, as some strains of the H Pylori bacteria are resistent to it (it is used in so commonly used).

http://www.ncbi.nlm.nih.gov/pubmed/26075959 However, this combination looks good. Was just published 6/15/2015 from a Japanese study. This combination was 92% successful using: a 7 day treatment of rabeprazole 10 mg four times daily (q.d.s.), metronidazole 250 mg twice daily (b.d.) and sitafloxacin 100 mg b.d.

[Zamunda]

Hi Sunshine ,

Thank you so much for your detailed response . I will follow some of your advices .
In the hPylori treatment guidelines link you provided , there is no combination for Amoxicillin and flagyl ( only biaxin with Metrozinadole for people with penicillin allergy ) and I did not find
anything that shows these two combinations are administered in North America . The only place is in Japan for patients that failed first line treatment .

http://www.ncbi.nlm.nih.gov/m/pubmed/18209581/

Metrozinadole resistance rate is close to 40% in Canada . That is what made me wary of this prescription . However , I will get second opinion next week . Thanks for the other new info from Japan, but I hope we would not need it .

[sunshine37]

You're welcome, Zamunda..