Helicobacter Forums

Dear Prof. Kimura,
I have multi-resistant H.p. infection with high MIC's (clarithromycin, metronidazole, levofloxacin, rifabutin) and therefore I'm interested to know if somewhere in the world topical administration of antimicrobal agents is applied. If system therapy is not applicable, maybe local (topical) treatment could be of help. What do you think?
Thank you,
Davorin

By topical treatments, I recall Japanese investigators who used a balloon to stop the stomach emptying then they filled the stomach with bismuth and penicillin. After an hour or so they released the balloon. It did work in quite a few patients but needs a dedicated team to do it.
Usually, topical treatments might start with bismuth salts - De-Nol or Pepto-Bismol - 2 tabs qid. Take with food to delay the emptying of the medicine. Take with a PPI such as high dose omeprazole 20 mg qid or equivalent (3x-4x normal dose). Also, there is some data that shows disappearance of Hp in some people who take the lactobacilli yoghurt "LG21" or the Korean product "WILL". I have appeared in publicity campaigns for these products that is how I know about them. You cannot obtain them outside Japan and Korea though .I have'nt reviewed that data recently.

Hello,
sounds good, indeed my idea is to use the topical treatment as a pre-treatment.
I'll take bismuth with a small amount of food and roll in the bed (change positions). I read that a similar "roll therapy" was applied in Germany some time ago
Any idea which kind of food would enable better penetration of bismuth into the gastric mucosa (f.e. indigestible food like fibers)?

Soft food is best - and even take the bismuth in smaller dose (one tab chewed or Pepto-Bismol equivalent liquid to 250 mg of BSS) - EVERY THREE HOURS - because residence time in the stomach is less than 3 hous.
The Japanese used a mucolytic called pronase which is a natural product. Actually, we have an old FAQ on this website at the URL http://www.helico.com/treat_topical.html - even a picture of Dr Ken Kimura (he is semi retired now though).