quadruple therapy

[Mary]

Dear H pylori expert,
I started triple therapy January of 2018 and was tested positive. I began quadruple therapy on May 2018 (Amoxicillin 500mg 2 capsules x 2 per day + Metronidazole 1 200mg x 4 per day + Bismuth 1 x 4 per day + PPI) . I however skipped day 14th of the therapy since I was very sick. but finished 13 days of therapy completely .
Since then, I am still on PPI 40mg/day for having acid reflux symptom. I have not had a chance to take the test since I am on PPI. Sometimes I think if not taking day 14th regimen had not killed all the bacteria. can this be true?
Another question I have is about the effectiveness of PPI. I have been taking pantoprazole (generic from Teva). I also was on omeprazole for a month before I switched to pantoprazole which is more effective but not quite as I expected. I still have occasional acid reflux . What do you think if I go on dexilant? I heard it is the most effective one. I am not intending to go on another round of antibiotics at least for another year if I have still bacteria lingering around.
I appreciate your responses.
Thank you

[Helico_expert]

Hi Mary,

13 days is good enough. We normally only give our patients 10 days therapy and we have a cure rate of 95%. Some doctors think that 14 days is better because you probably get 96-97% cure rate. Which we think the difference is insignificant if you take the side effect into consideration.

As for the PPI, everyone react differently to the PPI. if you think Pantoprazole is not good enough, you can switch to other PPI. We like to use rabeprazole as it works on most people.

alternatively, you can ask your doctor for higher dose of pantoprazole.

[Mary]

Thank you so much for taking time to reply