14 days versus 7 days

The cure of Hp usually requires antibiotics. Other things have been tried and have a weaker effect.

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cvs
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14 days versus 7 days

Post by cvs » Mon Mar 18, 2019 2:54 am

I wondered why if 14 days triple treatment is more effective than 10 or 7 days the UK guidelines are for 7 days treatment.

I am in the UK and taking a second course of triple therapy of Lansoprazole 30mg bd Amoxicillin 1g bd and metronidazole 400mg bd for 7 days. I was in fact given enough to cover 10 days and told to discard the rest after 7 days but I'm going to take 10 days as I have it.

Helico_expert
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Re: 14 days versus 7 days

Post by Helico_expert » Mon Mar 18, 2019 9:57 am

good question. some literature suggests that 7 days give about 80% cure rate, while 10 days gives about 85% and 14 days give about 87%. Some doctors argue that the few % increment is insignificant. and of course, the longer you take the antibiotics, the more side effects you will be experiencing. Also, it is going to become resistant to those antibiotics, it really doesnt matter how much longer you take the antibiotics. So some doctors prefer 7 days and can switch to another regimen quickly.

nevertheless, you can boost standard the treatment by taking double standard dose PPI and with additional bismuth to make it a quadruple therapy.

cvs
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Re: 14 days versus 7 days

Post by cvs » Mon Mar 18, 2019 3:04 pm

Thank you for your reply. Do you mean if it is already resistant to antibiotics taking them for longer is pointless or the longer you take antibiotics the more likely resistance is to occur?

I am about to do days 7 to 10 and if this will cause remaining bugs to become resistant I will stop. Unfortunately it is too late for the bismuth.

cvs
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Re: 14 days versus 7 days

Post by cvs » Mon Mar 18, 2019 3:20 pm

I am finding this regimen easier to tolerate than the one with clarythromycin so I thought I'd persevere for 10 days in the hopes of eradicating it this time. I have a repeat endoscopy in a month to check the ulcers have healed. I have to continue lan soprazole 30mg bd for another 3 weeks still.

Helico_expert
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Re: 14 days versus 7 days

Post by Helico_expert » Tue Mar 19, 2019 9:49 am

yup. go ahead with the lansoprazole. but make sure you discuss with your doctor about follow up test to find out if your HP is eradicated.

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