H-pylori Treatment

[msuej]

My husband has previously been treated for an ulcer. Recently he began having symptoms of what we thought was severe acid reflux. He went to the doctor where he was tested for the H-pylori bacteria. The test came back positive, but his doctor is only suggesting he take Prevacid. Everywhere I have read says that he should be taking some sort of antibiotic. I do not want him to go "untreated" and wind up with more severe issues (i.e. stomach cancer, etc.) down the road. What is your thoughts on this?

Thanks!

[msuej]

Thank You so much. That is what I thought from my reading, but I wanted to be sure.

[actudan]

I concur with hyasnthgrl except that I will add that h-pylori can be a tough case to treat but it is treatable. Sometimes it takes a 2,3 or 4 "package". The package includes a broad sprectrum of antibiotics plus a PPI. Good luck!

[suzyshop1]

Your husbands doctor must be a quack.PPI"S are not going to kill h.pylori.First i'd suggest you find a new doctor.Standard treatment is 2 antibiotics and a ppi for2 wks.If the doctor doesnt treat the h.pylori it could progress to gastritis or an ulcer.Take care.

[actudan]

Originally Posted by suzyshop1

Your husbands doctor must be a quack.PPI"S are not going to kill h.pylori.First i'd suggest you find a new doctor.Standard treatment is 2 antibiotics and a ppi for2 wks.If the doctor doesnt treat the h.pylori it could progress to gastritis or an ulcer.Take care.

I agree with Suzy. There are up to 4 (from what I have read) broad sprectum antibiotic treatments. The standard treatment is 1 - 2 antibiotics. I guess the wider spectrum are for those difficult cases. A ppi is given for the acid suppression. The ppi in conjunction with the antibiotics help alleviate ulcer-related symptoms (i.e. abdominal pain, nausea), helps heal gastric mucosal inflammation, and may enhance the antibiotics effect against h-pylori. The ppi itself does NOT treat h-pylori but in my opinion may help it to spread since acids kill a lot of bad bacteria.

From the cdc.gov website on treatments:

FDA-approved treatment options
Omeprazole 40 mg QD + clarithromycin 500 mg TID x 2 wks, then omeprazole 20 mg QD x 2 wks

-OR-

Ranitidine bismuth citrate (RBC) 400 mg BID + clarithromycin 500 mg TID x 2 wks, then RBC 400 mg BID x 2 wks

-OR-

Bismuth subsalicylate (Pepto Bismol®) 525 mg QID + metronidazole 250 mg QID + tetracycline 500 mg QID* x 2 wks + H2 receptor antagonist therapy as directed x 4 wks

-OR-

Lansoprazole 30 mg BID + amoxicillin 1 g BID + clarithromycin 500 mg TID x 10 days

-OR-

Lansoprazole 30 mg TID + amoxicillin 1 g TID x 2 wks**

-OR-

Rantidine bismuth citrate 400 mg BID + clarithromycin 500 mg BID x 2 wks, then RBC 400 mg BID x 2 wks

-OR-

Omeprazole 20 mg BID + clarithromycin 500 mg BID + amoxicillin 1 g BID x 10 days

-OR-

Lansoprazole 30 mg BID + clarithromycin 500 mg BID + amoxicillin 1 g BID x 10 days

*Although not FDA approved, amoxicillin has been substituted for tetracycline for patients for whom tetracycline is not recommended.

**This dual therapy regimen has restrictive labeling. It is indicated for patients who are either allergic or intolerant to clarithromycin or for infections with known or suspected resistance to clarithromycin.


Note: Moderator, I copied the cdc.gov info but I did state where the info came from. I hope that is ok with policy.