Helicobacter Forums

I discussed the quadruple dosages you proposed with my doctor, and he suggested the following:

Metronidazole 500mg tab
Rabeprazol 20mg tab
Refabutin 150mg tab
Ciprofloxacin 500mg tab

He replaced the Amoxicilin with Metronidazole.

What do you think?

Thank you so much in advance

I think Amoxicillin is the best antibiotic against H. pylori and shouldnt be replaced. Amoxicillin is safe and very little side effect.
Most importantly, H. pylori can never become resistant to Amoxicillin.


If you have access to Bismuth, try get that as well. H. pylori can never resistant to Bismuth too.

So, why did the previous three dosages fail to eradicate it? Besides, I have read some studies that indicate that H Pylori can get resistant to Amoxicilin.
Regarding bismuth, I read a study that says that it has very undesirable side-effects that it was forbidden in Europe.

Two more questions:
1- How and when can I take probiotics while taking the quadruple treatment?
2- What is the most appropriate way of taking the treatment? I might have done something wrong in my previous treatments?

Thank you so much,,,

There are some reports of Amoxicillin resistance. But that's because those studies used a very low cut off point. We do not 100% agree on those cut off values.

your previous treatment failed not because of Amox. It's because of the other antibiotic.

Bismuth is banned in Europe because it makes your stool very dark. Many doctors mis diagnosed that as internal bleeding. Hence, to reduce panic, they banned the use of bismuth. Nevertheless, in their consensus guideline, they agreed that bismuth should be use when there is antibiotic resistance.

there is no guideline of how to use probiotics. So i guess you can take it after antibiotics.

if you complete your antibiotics on time, then you did not do anything wrong. The main reason for treatment failure is due to antibiotic resistance.

Thank you for your reply,
I just want to tell you that I did not find Rifabutin in the biggest pharmacies in my country, and I am not sure if I can find Furazolidone too. What do you suggest?

Thanks again,,,

yea, they are control drugs. only specialist will be able to get them. the easier choice is pylera.

http://www.webmd.com/drugs/2/drug-14795 ... al/details

What about
Rabeprazole (PPI)
DeNol (Bismuth)
Amoxicillin
Tetracycline
?
I think it is available.
And FYI we don't have drug-controlling in my country. You can get whatever you want without A prescription.

Amoxicillin and Tetracycline are funny combination. because amoxicillin only works when the cells are actively dividing. It inhibits the making of the cell wall. So the cell divide without a cell wall and they die.

Tetracycline on the other hand stop cell from growing (or dividing). If the bacteria cell is not dividing, eventually they'll be all killed by immune cell or acid.

so when you mix amoxicillin and tetracycline, they sort of counter each other. So, in theory, the combination wont work. But some studies showed some success.

I personally dont think it's a good idea to risk this combination, unless there is no other resolution.

So what other options do you recommend?
You left me puzzled

have you had metronidazole before? if not, how about PPI + Amox (1000mg tablet, 3 times a day) + Bismuth (2x 120mg tablet, 4 times a day) + Metronidazole (400mg tablet, 3 times a day)?

take at least 10 days up to 14 days.