Helicobacter Forums

Can adding Tetracycline overcome Metronidazole resistance due to multiple previous exposure, even in the area where Metronidazole resistance is over 60%?

Is this regime good enough? What about side effects?

Metronidazole QID
Tetracycline TID
Pepto Bismol QID
Rabeprazole TID

Yup. There are multiple reports about overcoming Met resistance by using Tetracycline in the treatment.

This is a good treatment with cure rate over 90%.
Metronidazole QID
Tetracycline TID
Pepto Bismol QID
Rabeprazole TID

The side effect is mild. Just make sure you know that pepto bismol can give you very dark stool. Some people thinks that they have internal bleeding because of the dark stool.

Could you please write correct dosage and duration of this regimen? 7, 10 or 14 days?

Is Rabeprazole BID enough instead TID? Does Pylopass and NAC increase eradication rate?

We find higher dose PPI improve cure rate.

Rabeprazole 20mg TID
bismuth 240mg QID
Tetracycline 500mg QID
Metronidazole 400mg TID

10 days treatment

Alternatively you can follow the PYLERA instruction
https://www.rxlist.com/pylera-capsules- ... escription

If a person took Metronidazole twice during last year, would be a dose 400 mg TID sufficient to overcome resistance?

And could we take tetracycline with food, or is it preferable on empty stomach?

Good question! I guess it depends on how resistant is your strain resistant to Metronidazole. If you are worried, perhaps you should ask your doctor to replace metronidazole with other antibiotics such as rifabutin or furazolidone?

resistance to antibiotic is not 0 and 1 (yes and no). There is a level of resistance. For those that are mid range resistance to metronidazole, definitely it can be overcome by having higher dose.

We dont find a difference between taking it with or without food. It is more important to take the pills at a evenly distributed time. So the antibiotics concentration is constantly high in your blood stream.

Resistance to Metronidazole is high in this area, around 50%, and low to tetracycline. They prescribe rifabutin only for Tuberculosis.

yup. rifabutin can also be used for H. pylori.

Crawler wrote: Thu Apr 01, 2021 1:07 pm Resistance to Metronidazole is high in this area, around 50%, and low to tetracycline. They prescribe rifabutin only for Tuberculosis.

What area is that?

Helico_expert wrote: Thu Apr 01, 2021 2:00 pm yup. rifabutin can also be used for H. pylori.

They keep rifabutin only for cases of tuberculosis, it's unavailable for h.pylori.

First line therapy failed - Clarithromycin, Metronidazole, Pantoprazole. Penicilin allergy.