Should triple therapy be used as a first line treatment for H pylori?
Nonetheless it stated that there was still a role for triple therapy as first line therapy for H. pylori infection[1]. The Maastricht IV consensus recommended that if the treatment population was known to have a clarithromycin resistance rate above 20%, clarithromycin-containing triple therapy should be avoided.
What happens if H pylori infection is not treated?
About 20% of H. pylori treatment fails after initial treatment. Make sure that the patient is compliant with medications. Since the patient has failed an initial course of treatment, we will use an alternate regimen (triple or quadruple therapy) using a different combination of antibiotics for 14 days.
Why do some people become unresponsive to treatment for Helicobacter pylori?
Medically there was no obvious explanation for why people who had never been treated for H. pylori were now becoming unresponsive to a protocol, which up to this point had been very successful. Energetically there was an answer, for me anyway, based on the research done by Rupert Sheldrake, Ph.D., in Morphic Fields and Morphic Resonance .
Can H pylorieradication be achieved after two or more unsuccessful attempts?
Even after two consecutive failures, several studies have demonstrated that H pylorieradication can finally be achieved in almost all patients if several rescue therapies are consecutively given. Therefore, the attitude in H pylorieradication therapy failure, even after two or more unsuccessful attempts, should be to fight and not to surrender.
What happens if H. pylori treatment doesn't work?
pylori infected persons have a 10 to 20% lifetime risk of developing ulcer and a 1 to 2% lifetime risk of developing gastric cancer [4]. With increase resistance to clarithromycin worldwide there is an increased risk of first line H. pylori treatment failure [5, 6].
Why can't I get rid of my H. pylori?
Unfortunately, H. pylori is extremely difficult to remove. Due to the unique characteristics of the bacteria, it is able to create reservoirs that are protected by the biology of the stomach itself. Even if the reservoirs are eliminated, it may allow new mutant strains of H.
Why do I still have H. pylori after treatment?
The treatment of H. pylori is not always successful, and one may have a recurrence of the bacterial infection and the ulcer. There also can be another cause for the ulcer not healing such as continued smoking of cigarettes or taking certain ulcer-causing drugs like NSAIDs (ibuprofen, Motrin, naprosyn, aspirin etc.).
Why is it difficult to control H pylori infection?
The survival capabilities of H pylori in the stomach make it difficult to eradicate, and effective treatment requires multidrug regimens consisting of two antibiotics (usually selected from clarithromycin, metronidazole, amoxicillin, and tetracycline), combined with acid suppressants and bismuth compounds.
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.
What happens if antibiotics don't work?
When bacteria become resistant, the original antibiotic can no longer kill them. These germs can grow and spread. They can cause infections that are hard to treat. Sometimes they can even spread the resistance to other bacteria that they meet.
How do you know if H. pylori treatment is working?
Guidelines recommend that all patients treated for H. pylori undergo a breath or stool test two weeks after finishing the medication [1-3]. This is done to be sure that the bacteria were killed.
How long does it take for stomach to heal after H. pylori?
If you have ulcers caused by H. pylori, you'll need treatment to kill the germs, heal your stomach lining, and keep the sores from coming back. It usually takes 1 to 2 weeks of treatment to get better.
How long H. pylori go away after treatment?
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 do you know when H. pylori is gone after treatment?
Stool tests: Your doctor can test your poop for proteins that are a sign of H. pylori. This test can identify an active infection and can also be used to check that an infection has cleared after treatment.
What is the latest treatment for H. pylori?
The first potassium-competitive acid blocker (PCAB)–based therapy was approved by the US Food and Drug Administration (FDA) in May 2022 and consists of the following for triple therapy: Vonoprazan (PCAB) 20 mg BID plus amoxicillin 1000 mg BID plus clarithromycin 500 mg BID for 14 days.
What is the most effective treatment for H. pylori?
To date, the bismuth-based triple therapies are the most effective and least costly treatments for the eradication of H pylori, because they have high cure rates even in those patients infected with metronidazole-resistant strains.
How to treat H pylori?
H. Pylori Treatment Failure 1 About 20% of H. pylori treatment fails after initial treatment. 2 Make sure that the patient is compliant with medications. 3 Since the patient has failed an initial course of treatment, we will use an alternate regimen (triple or quadruple therapy) using a different combination of antibiotics for 14 days. 4 We won’t use Clarithromycin unless we have cultures that show that this H. pylori strain is susceptible to Clarithromycin. 5 Will avoid antibiotics that have been used before. 6 Will consider culture with antibiotic sensitivity testing to guide subsequent treatments if the patient fails the second antibiotic combination. 7 Rx: omeprazole (20 mg BID), tetracycline (500 mg BID), metronidazole (500 mg BID), and bismuth subcitrate caplets (240 mg BID), each given twice daily with the midday and evening meals for 14 days 8 Rx: Florastor to prevent C-diff.
How often should I take PPI?
Standard dose PPI* twice daily (or esomeprazole 40 mg once daily) plus clarithromycin 500 mg twice daily, and amoxicillin 1000 mg twice daily for 10-14 days ¶.
How long does a PPI last?
Levofloxacin (250 mg), amoxicillin (1 g), and a PPI each given twice daily for 14 days. Omeprazole (20 mg), tetracycline (500 mg), metronidazole (500 mg), and bismuth subcitrate caplets (240 mg), each given twice daily with the midday and evening meals for 14 days has been shown to result in a 95% eradication rate.
How long does it take to take clarithromycin 500 mg twice daily?
Standard dose PPI twice daily, clarithromycin 500 mg twice daily, metronidazole 500 mg twice daily for 10-14 days ¶.
Can you use clarithromycin on H. pylori?
We won’t use Clarithromycin unless we have cultures that show that this H. pylori strain is susceptible to Clarithromycin.
First treatment didn't work..
My GI did an endoscopy and confirmed Hp. He put me on a 14 day course of Clarithromycin 500mg 2x day, Omerprazole 40mg 2x day, and Amocicillin 500mg 2x day. I am one day away from finishing treatment. For the first ten days everything worked beautifully, but on day 11 my diarrhea came back and on day 12 my stomach pains came back.
Re: First treatment didn't work..
Hello - my treatment didn't seem to work as well, I was on the 4 capsule/tablet treatment 2 nexium & 2 Amoxicillin I'm not 100% sure weather it was Amoxicillin as I cant remember, It was a 7 day treatment, it started very well I felt much better, the condition I had was for 4 years after countless visits to the doctor with CT scans xrays etc, my doctor could not figure this out, all I knew is that I had stomach pain & quite serve at times, so I left it for a year as my doctor had no answer for me, but I went back & demanded more tests & FINALLY had a breath test & there it was H-PYLORY, (i've had 1 treatment only) as I said I felt better and the treatment seemed to work & I 'generally' feel better but I still have a bit of stomach pain with the usual symptoms ie tight chest, pain in different parts of tummy, constipation, these symptoms seem to come and go I'll be all right for some weeks then it will appear again, (I have had a second breath test & it was negative?) but yet I still have symptoms, not as bad but yet still there I dont know what else to do? I am 35 years old & this has been a frustrating annoying problem that just seems to linger my energy levels are all over place my moods vary a bit, as I read that h-pylori can lead to depression & such, please anyone, can you recommend some treatment to cure this for once and for all! 5 years of this is enough! my doctor says your second test is negative? but still discomfort is there? *Upon doing some research I found an interesting site http://h-pylori-symptoms.com there seems to be some natural treatments/cures for HP, please have a look! this guy talks about matula herbal formula, & the need to cut out certain foods like: cows milk, soy, & gluten, doe's anyone know if there is a true basis for this treatment? as Im willing to try anything at the moment to get rid of this for once and for all! Tim..
Re: First treatment didn't work..
i just got dx on mon... and started on the 7 days course meds (klacid HP7)... I notice that after taking it (all 3 pills before meal), the pain gets better... only to find that it comes back with a vengence about 1 hour later after food... does this means the antibiotics is working?
How many days of triple therapy for Helicobacter pylori?
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%. Ten-day regimens produce higher cure rates than 7-day regimens. Repeating the initial clarithromycin-based triple therapy cures fewer than half of patients (strength of recommendation [SOR]: A, meta-analyses of randomized controlled trials [RCTs]).
What is the cure rate for metronidazole?
Treating with a metronidazole-based triple therapy (with amoxicillin and a PPI) also produces high (87%) cure rates (SOR: A, meta-analyses of RCTs in exclusively Japanese populations).
Is bismuth based quadruple therapy available?
Bismuth-based quadruple therapy has a more complex dosing regimen, and bismuth isn’t available in some countries. Rising rates of H pylori resistance to levofloxacin in certain areas could make levofloxacin-based triple therapy less effective in the future (SOR: C, expert opinion-based guidelines). References. 1.
