Best treatment after failures

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NoxArcana
Posts: 28
Joined: Thu Feb 07, 2019 12:05 am

Best treatment after failures

Post by NoxArcana » Thu Mar 28, 2019 7:56 am

Hello, i received the results from my biopsy and the treatment failed again, and i would like to know, what is the treatment with higher cure rate after both triple therapy failure? My first was clarithromycin 500mg every 12h, amoxicillin 1g every 12h and lansoprazole 30mg every 12h, the second was levofloxacin 500mg 1 time a day, amoxicillin 1g every 12h and lansoprazole 30mg every 12h.

Helico_expert
Site Admin
Posts: 3521
Joined: Wed Mar 02, 2011 7:20 am

Re: Best treatment after failures

Post by Helico_expert » Fri Mar 29, 2019 7:10 am

Hi, you can talk to your doctor about the following treatment

High dose PPI, eg. Rabeprazole 20mg 3 TID
High dose bismuth, 220 mg QID
Tetracycline, 500mg QID
Metronidazole 400 mg TID

This combination is very similar to Pylera.

NoxArcana
Posts: 28
Joined: Thu Feb 07, 2019 12:05 am

Re: Best treatment after failures

Post by NoxArcana » Fri Mar 29, 2019 7:46 am

Thanks for your feedback, i'll talk with him tomorrow, i hope that this one Works.

NoxArcana
Posts: 28
Joined: Thu Feb 07, 2019 12:05 am

Re: Best treatment after failures

Post by NoxArcana » Fri Mar 29, 2019 9:57 pm

Hello again, i need your opinion, i talk with the doctor about your recommendations, and then he told me that the quadruple therapy is hard to do because bismuth is not widely available in my country, he then recommended a treatment with moxifloxacin 400mg and omeprazole, i didnt find any study using only one antibiotic, but did find triple therapy with moxifloxacin, amoxicilin and lansoprazole, i even told him if i shouldnt take more than one antibiotic and then he told that only moxifloxacin is fine, i find this quite weird, so what do you think, should i go to another specialist and insist in quadruple therapy?

Helico_expert
Site Admin
Posts: 3521
Joined: Wed Mar 02, 2011 7:20 am

Re: Best treatment after failures

Post by Helico_expert » Sat Mar 30, 2019 6:12 am

i think you should go to another specialist.

Moxifloxacin and levofloxacin are the same class, which you had tried and failed. Therefore, you should not try again.

And you are right about single antibiotic treatment, the success rate will be too low.

NoxArcana
Posts: 28
Joined: Thu Feb 07, 2019 12:05 am

Re: Best treatment after failures

Post by NoxArcana » Fri Apr 05, 2019 8:51 am

Hello, i found a better doctor and he prescribed the therapy that you recommended, i'll start next week. I am a little worried about the side effects, i had a lot with the first therapy, is this one worse than with clarithromycin?

Helico_expert
Site Admin
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Joined: Wed Mar 02, 2011 7:20 am

Re: Best treatment after failures

Post by Helico_expert » Fri Apr 05, 2019 1:36 pm

everyone reacted differently to the antibiotics. but in general, tetracycline does have more side effects than clarithromycin. do discuss the side effects with your doctors.

if the side effect is not too difficult, do try to finish the course to avoid resistance. i dont want to tell you too much about the side effect. usually the more you know, the more likely you'll feel it.

NoxArcana
Posts: 28
Joined: Thu Feb 07, 2019 12:05 am

Re: Best treatment after failures

Post by NoxArcana » Fri Apr 05, 2019 7:44 pm

Thanks for your answers, i ask him about what side effects should i expect, he said that is very common nausea and vomiting, this type of side effects do not scare me, that is normal, i asked him more about some side effect that could be dangerous in comparison with clarithromycin or levo, because when i was taking levo my stool became almost white, i got scared because this is a sign of problems with the liver, then i went to hospital and they told me that this is normal when you take fluoroquinolones. But even with lot of side effects i'll not interrupt the treatment, i know that this is the worst decision.

Helico_expert
Site Admin
Posts: 3521
Joined: Wed Mar 02, 2011 7:20 am

Re: Best treatment after failures

Post by Helico_expert » Sat Apr 06, 2019 1:40 am

All the best to your treatment.

NoxArcana
Posts: 28
Joined: Thu Feb 07, 2019 12:05 am

Re: Best treatment after failures

Post by NoxArcana » Wed Apr 10, 2019 7:30 pm

Hello helico, so, before i started my treatment i did an hepatogram and my TGO and TGP are high(50/115UI) and my doctor prescribed a medication with silybum marianum, it is ok to take this medication with the quadruple therapy? thanks

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