Salvage Therapy

After first line treatment, various "second line" treatments can be used. The policy for H.pylori is: Make sure the infection is real (breath test for follow-up). Always give a high dose of PPI (acid blocker) when using amoxicillin. In the second treatment, give a different drug in place of clarithromycin.

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Giveseba
Posts: 4
Joined: Sat Mar 30, 2019 9:38 pm

Salvage Therapy

Post by Giveseba » Sat Mar 30, 2019 10:15 pm

Hi
I’m hoping to get some guidance on here. I moved to Australia 9 years ago and have caught h pylori 5 times in total. I never had it when I lived in the US. The first time it happened in 2010 and It was cured with the standard therapy. Second time was in 2012 and I took the same therapy but it didn’t work so I looked up this site and saw some suggestions as to which antibiotics to take, I showed it to my GP and he gave me the following prescription:
-PPI (pariet) 20mg once a day for 14 days
-Ciprofloxacin 500 mg twice daily for 14 days
-Rifabutin 150mg twice a day for 14 days

I asked him to include the amoxicillin too but he suggested I skip it since it had failed during the first treatment. This cleared up the infection straight away. I somehow got reinfected about a year later and went back to the same gp and he gave me the exact same prescription which worked again. I got reinfected again about 1.5 years later and he gave me the same prescription and it worked again. I was completely symptom free after every treatment until I somehow got reinfected again about a month ago after being h pylori free for about 3 years.

My question is this: The suggestions page is not visible on this site anymore and this combination has worked for me 3 times but is this the recommended therapy? I can’t find it on here anymore and it’s definitely worked for me but I just want to make sure it’s the right combination... should the amoxicillin be included too? Should the ppi be increased? I tolerated this combination okay, and I cannot just leave the infection there as I’m not one of those people who doesn’t experience symptoms from it, my symptoms are pretty severe when I have it; nausea, bad taste in mouth, constant hunger pains, heartburn, burp constantly, bloated ect... any advice would be greatly appreciated
Thanks

Also, I’m pretty paranoid about this infection as it seems I’m the only one in my family that keeps catching it so I feel as if I’m susceptible to it somehow and I also worked with a lady who had h pylori that went undiagnosed for years until it turned into stomach cancer.

Giveseba
Posts: 4
Joined: Sat Mar 30, 2019 9:38 pm

Re: Salvage Therapy

Post by Giveseba » Sat Mar 30, 2019 10:48 pm

Was I supposed to take it in a different way? I’d like my course to last more than 10 days just to make sure it clears up... Thanks

“The PARC consists of Rabeprazole (20 mg, 3 times daily for 10 days), AMX (1000 mg, 3 times daily for 10 days), RFB (150 mg, starting from day 6, 2 times daily for 5 days) and CIP (500 mg, starting from day 6, 2 times daily for 5 days)”

Helico_expert
Site Admin
Posts: 3301
Joined: Wed Mar 02, 2011 7:20 am

Re: Salvage Therapy

Post by Helico_expert » Sat Mar 30, 2019 11:17 pm

First of all, how did you know your first 3 treatments work? have you done a follow up breath test one month later after you completed the treatment to check if you still have H. pylori ?

reinfection is actually quite rare. Many people we treated almost never come back to us. we have a real reinfection in the past 6 years. We know it's a real reinfection by doing bacterial genome sequencing of the 1st and 2nd endoscopy.

Giveseba
Posts: 4
Joined: Sat Mar 30, 2019 9:38 pm

Re: Salvage Therapy

Post by Giveseba » Sun Mar 31, 2019 7:07 am

I followed up with a breath test the first 2 times But not the 3rd and 4th. Tested negative on both occasions and I didn’t bother the last 2 times as all the symptoms disappeared. As I said before, I was completely symptom free since taking this antibiotic combination almost 3.5 years ago...
Is is safe to take the same course that has worked for me (rifabutin, ciprofloxacin and a ppi for 14 days) or should I also be taking the amoxicillin combined with the rifabutin and ciprofloxacin?
Thanks

Helico_expert
Site Admin
Posts: 3301
Joined: Wed Mar 02, 2011 7:20 am

Re: Salvage Therapy

Post by Helico_expert » Sun Mar 31, 2019 7:11 am

if it's a true reinfection, then yes, you can take the same treatment again. But this is not very common. Should investigate where you catch H. pylori from.

Usually H. pylori is transmitted in a crowded and poor hygiene family. Brushing teeth is important to prevent spread. It's not easy to catch H. pylori from public unless the public's hygiene is equally poor. How many people live together with you under the same roof?

Giveseba
Posts: 4
Joined: Sat Mar 30, 2019 9:38 pm

Re: Salvage Therapy

Post by Giveseba » Sun Mar 31, 2019 7:48 am

I honestly have no idea where I keep getting it from, after the last reinfection In 2015 I became quite paranoid of everything I put in my mouth- don’t drink tap water or even brush my teeth with it, don’t eat much takeout, and I’m even paranoid of kissing but I let my guard down all of February and it would appear as if it’s happening from one of those 3 sources. That’s the only thing I’ve done differently since being reinfected a few weeks ago...
I should mention that I live in Perth so it seems to be an ongoing issue for me as I never had this infection during the 20 years I lived in the US. Not saying the infection doesn’t happen in the US or anything but I never caught it there.


My gp has given me the same prescription I took last time which doesn’t include the amoxicillin, is it important to include it since I read on this site that h pylori can’t become resistant to it?

Thanks so much for your input...

Helico_expert
Site Admin
Posts: 3301
Joined: Wed Mar 02, 2011 7:20 am

Re: Salvage Therapy

Post by Helico_expert » Sun Mar 31, 2019 11:54 pm

It's interesting that you keep getting it, especially living in Perth where H. pylori prevalence is so low.

Do you have your breath test records? can share with me?

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