Treatment FAQ

h pylori treatment when antibiotics have failed

by Dr. Darlene Dickens Published 2 years ago Updated 2 years ago

EVIDENCE-BASED ANSWER: Treating patients with Helicobacter pylori infection who have failed clarithromycin-based triple therapy with either levofloxacin-based triple therapy (with amoxicillin and a proton pump inhibitor [PPI]) or a bismuth-based quadruple therapy produces cure rates of 75% to 81%.

What happens if H. pylori doesn't go away with antibiotics?

If it's not treated, it can sometimes cause ulcers, which are painful, open sores in your stomach lining that bleed. Studies show that people who are infected with H. pylori are also up to 8 times more likely to get a certain kind of stomach, or gastric, cancer.

Can H. pylori treatment fail?

However, even with the current most effective treatment regimens, about 10% of patients will fail a variety of treatments and remainH pylori positive. Patient compliance, bacterial resistance to antibiotics, and the components of the regimen should be assessed when retreatment is considered.

What is the second treatment for H. pylori?

The Maastricht V/Florence Consensus Report recommends bismuth quadruple therapy, or fluoroquinolone-amoxicillin triple/quadruple therapy as the second-line therapy for H. pylori infection.

Can you still have H. pylori after treatment?

H pylori antibodies can remain present long after successful H pylori eradication. Biopsy-based testing including the rapid urease test or histology also can be used to document H pylori eradication.

Why does H. pylori treatment fail?

The H. pylori treatment failure has been linked to infections with antibiotic resistant strains [13,14,15,16], host genetic polymorphism in the cytochrome that may affect proton pump inhibitor pharmacokinetics (CYP2C19), poor adherence, short duration of therapy and smoking [17,18,19].

Can H. pylori come back after antibiotics?

We conclude that the rate of recurrence after successful H. pylori eradication is low, and that when reinfection takes place, it occurs most commonly within the 1st yr after treatment.

What is the triple treatment for H. pylori?

Abstract. Background: Triple therapy (proton pump inhibitor, clarithromycin and amoxicillin or an imidazole) is the first-line treatment for Helicobacter pylori infection. However, the effectiveness of triple therapy is decreasing due to the increase in antibiotic resistance.

When is quadruple treatment for H. pylori?

Nonbismuth quadruple therapy (i.e., concomitant) for 10 to 14 days (the Toronto Consensus strongly recommends 14 days) is another first-line regimen. This regimen may also be used as salvage therapy in patients with persistent H pylori infection when the primary or preferred therapy fails.

When should I recheck after H. pylori treatment?

Testing once is adequate, at least four to six weeks after treatment, and ideally off proton-pump-inhibitor therapy for one to two weeks and off any antibiotics or bismuth products for four weeks to avoid false-negative results.

How do you get rid of H. pylori completely?

pylori-caused ulcers are treated with a combination of antibiotics and an acid-reducing proton pump inhibitor. Antibiotics: Usually two antibiotics are prescribed. Among the common choices are amoxicillin, clarithromycin (Biaxin®), metronidazole (Flagyl®) and tetracycline.

How long does it take for stomach to heal after H. pylori?

pylori treatment usually includes several medicines. At least two of the medicines are antibiotics that help to kill the bacteria. The other medication causes the stomach to make less acid; lower acid levels help the ulcer to heal. Most people are cured after finishing two weeks of medicine.

How many classes of antibiotics do you take for H. pylori?

The Experts recommend giving triple therapy regimens as first-line eradication therapy for Helicobacter pylori infection. The recommended duration of triple therapy is 10-14 days. However, recent studies suggest triple therapy with longer duration will provide a higher percentage of eradication.

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