Helicobacter Forums

My doctor recently ran a blood test to where I tested positive for H. Pylori antigen. I’m awaiting on referral to see GI at Digestive Specialist. Back in 2011 I successfully fought C-diff which I was diagnosed with after being prescribed Clindamyacin from dentist. Recovery was slow and difficult.

I’m asking for advice on treatment of H Pylori knowing that I’m susceptible to C-diff. I would like to have knowledge in hand if indeed I’m diagnosed with H.Pylori.

Thank you
Justn

any quadruple therapy that contains bismuth can prevent C. diff.

so, if you had not tried rifabutin or ciprofloxacin before, you can ask your doctor about the following

rabeprazole 20mg TID
bismuth 220mg QID
rifabutin 150mg BID
ciprofloxacin 500mg BID

10 days treatment.

we gave this treatment to many of our patients and have not seen a C. diff complication.. (touch wood).

I was always told that Rifabutin and Cipro was a fluoroquinolone and this falls under the danger to cdiff category.

Would the bismuth-based quadruple therapy, includes bismuth, tetracycline, metronidazole, and a PPI for 10 to 14 days be better .....sharpe dosage. My doctor wanted to just give me a course of Amoxicillin after blood test....hence why I insisted on seeing a GI specialist. I want to arm myself with as much knowledge as possible fir best treatment.

Cipro is quinolone. Rifabutin is not.
Rabeprazole + Bismuth + Tetracycline + Metronidazole, 14 days treatment is a good one too.

Sure, here's a short version:

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Hi Justn,

Since you tested positive for H. pylori and have a history of C. diff after clindamycin, you're right to be cautious.

Key Points:

- Standard H. pylori treatment uses antibiotics like amoxicillin, clarithromycin, metronidazole, and a PPI.
- These can increase C. diff risk, though not as much as clindamycin.

What to Ask Your GI:

1. Can we use a low-risk antibiotic combo?
2. Is culture-based treatment an option?
3. Can I take probiotics (e.g., Saccharomyces boulardii) during treatment?
4. What signs of C. diff should I watch for?

With the right plan, you can treat H. pylori safely. Let me know if you'd like help preparing questions for your doctor.

Considering your history of Clostridium difficile (C-diff) infection and the recent positive test for Hsnow road. Pylori antigen, what are the potential implications of antibiotic therapy for H. Pylori treatment on your gut microbiome, and how might these implications influence the choice of treatment regimen to minimize the risk of C-diff recurrence?

Thanks for this thread — it's really helpful. I’m also in a similar boat, having had a rough C. diff episode in the past and now testing positive for H. pylori. I’ve been really cautious subway surfers about any treatment that might trigger another round of C. diff.
I’ve heard good things about the bismuth-based quadruple therapy as being safer in that regard, especially since it avoids clindamycin, which was my trigger last time too. Curious if anyone else here has done the bismuth + tetracycline + metronidazole combo and how well it was tolerated?

Clindamycin, fluoroquinolones (like levofloxacin), and third-gen cephalosporins should be avoided if possible due to higher CDI risk word hurdle

Justm wrote: Thu Aug 15, 2019 8:30 pm I was always told that Rifabutin and Cipro was a fluoroquinolone and this falls under the danger to cdiff category.
nulls clash
Would the bismuth-based quadruple therapy, includes bismuth, tetracycline, metronidazole, and a PPI for 10 to 14 days be better .....sharpe dosage. My doctor wanted to just give me a course of Amoxicillin after blood test....hence why I insisted on seeing a GI specialist. I want to arm myself with as much knowledge as possible fir best treatment.

you mentioned diagnosing the H. Pylori via a blood test originally. Did you ever get that confirmed with a breath or stool test before starting the meds? I've heard blood tests can show positive even from old infections, and I'd hate to risk a C. diff relapse for an infection I might not actually have active right now.

it is true that blood test can only tell you if you had been expose to H. pylori. The antibody in your blood can stay positive for months or years. therefore, it is important to reconfirm your infection by breath test.