what the therapy for second course of h. pylory

Second-line therapy: quadruple therapy A 14-day course of "quadruple therapy" with a proton pump inhibitor, bismuth, tetracycline, and metronidazole or tinidazole is a more complicated but also more effective regimen.

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What is the second-line treatment for Helicobacter pylori (HP) infection?

Dore et al. prescribed a quadruple combination of PPI, bismuth, tetracycline, and metronidazole to patients who had failed two or more treatment courses of H. pylori eradication therapy (33 patients had failed prior treatment twice, 19 had failed three times, and 16 had failed four or more times); despite this a priori difficult task, H. pylori eradication was finally achieved in 93% of the …

What is the treatment regimen for H pylori failure?

Feb 14, 2014 · Empirical modified sequential therapy containing levofloxacin and high-dose esomeprazole in second-line therapy for Helicobacter pylori infection: a multicentre clinical trial. J Antimicrob Chemother.

Should triple therapy be used as a first line treatment for H pylori?

Sep 20, 2005 · Dual Therapy With High-Dose of Rabeprazole and Amoxicilline Versus Triple Therapy With Rabeprazole, Amoxicilline and Metronidazole as the Second Line Therapy for the Cure of H. Pylori Infection: Study Start Date : August 2003

What is ‘rescue’ therapy for Helicobacter pylori infection?

A meta-analysis of RCTs evaluating levofloxacin-based triple therapy as a secondary treatment regimen for patients with H pylori infection who had failed initial clarithromycin-based triple therapy found cure rates averaging 76% (TABLE). 1 Most of the regimens comprised levofloxacin (500 mg), amoxicillin (1 g), and a PPI (40 mg), all twice daily for 7 to 10 days. Ten-day regimens …

What is the second line of treatment for H. pylori?

Second Line Therapy for the Cure of Helicobacter Pylori (H. Pylori) InfectionPrimary Purpose:TreatmentOfficial Title:Dual Therapy With High-Dose of Rabeprazole and Amoxicilline Versus Triple Therapy With Rabeprazole, Amoxicilline and Metronidazole as the Second Line Therapy for the Cure of H. Pylori Infection6 more rows

When do you repeat H. pylori treatment?

Guidelines recommend that all patients treated for H. pylori undergo a breath or stool test two weeks after finishing the medication [1-3]. This is done to be sure that the bacteria were killed.Jul 6, 2020

How many treatments does it take to get rid of H. pylori?

Treatment for H. pylori infection is challenging. It usually involves taking a combination of three or four medications multiple times a day for 14 days.Apr 5, 2017

Which drug is used as second line salvage therapy for persistent H. pylori infection?

Levofloxacin-sequential therapy as second-line Zullo et al[74] first proposed the idea of sequential therapy; the regimen of PPI and amoxicillin for 5 d, followed by clarithromycin, metronidazole and PPI for the next 5 d, appeared to be more effective than standard triple therapy in 1st-line treatment.Feb 14, 2014

How do you prevent H. pylori from coming back?

H. Pylori PreventionPractice good hygiene and hand washing, especially with food preparation.All patients with chronic gastrointestinal symptoms that may be associated with H. ... Patients should complete the full course of therapy (antibiotics and acid blockers) to maximize the potential for a cure.More items...

How do you prevent H. pylori from recurrence?

To eliminate H. pylori infection and prevent its recurrence, physicians can use various combinations of medications, including antibiotics and proton pump inhibitors (which reduce stomach acid production). This is known as eradication therapy.Feb 7, 2016

What is the triple therapy for H. pylori?

Clarithromycin triple therapy consists of a PPI, clarithromycin (Biaxin), and amoxicillin or metronidazole (Flagyl) for 14 days. The effect of H. pylori resistance to clarithromycin is well documented.Jan 15, 2018

How do I know if my H. pylori is gone?

Stool tests: Your doctor can test your poop for proteins that are a sign of H. pylori. This test can identify an active infection and can also be used to check that an infection has cleared after treatment.Apr 24, 2021

Can H. pylori come back after treatment?

Recurrence of H pylori after a successful eradication is rare in developed countries and more frequent in developing countries[1]. Recrudescence (recolonization of the same strain) rather than reinfection (colonization with a new strain) is considered more likely to be responsible for most of the cases[5].Mar 14, 2008

What is the best treatment for Helicobacter pylori?

For the last two decades, the recommended treatment for H. pylori eradication is the standard triple therapy (Papastergiou et al. 2014a, b), using a proton pump inhibitor or ranitidine bismuth citrate, combined with clarithromycin and amoxicillin or metronidazole.

What is quadruple therapy for H. pylori?

Quadruple therapy (proton pump inhibitor, tetracycline, metronidazole and a bismuth salt) is a very effective regimen even in areas of high prevalence of antibiotic resistance, and may be an alternative first-line treatment.

What is first-line treatment for H. pylori?

Most patients will be better served by first-line treatment with bismuth quadruple therapy or concomitant therapy consisting of a PPI, clarithromycin, amoxicillin, and metronidazole. When first-line therapy fails, a salvage regimen should avoid antibiotics that were previously used.

How to get rid of H. pylori?

H. pylori is killed by certain antibiotics. However, a combination of medicines is needed to get rid of it completely. This is referred to as combination therapy although because it gets rid of (eradicates) the germ it is also referred to as eradication therapy. You need to take two antibiotics at the same time.

How long does it take for H pylori to go away?

pylori has gone if your symptoms come back after treatment. If you have a gastric or duodenal ulcer, testing is usually done 6-8 weeks after treatment.

What is the cause of ulcers in the stomach?

Infection with Helicobacter pylori ( H. pylori) is the cause of most stomach and duodenal ulcers. H. pylori also causes some cases of non-ulcer dyspepsia. Infection with H. pylori can be confirmed by a test done on a sample of stools (faeces), by a breath test, by a blood test, or from a biopsy sample taken during a gastroscopy (endoscopy).

Where does H pylori live?

These people do not know that they are infected. A number of H. pylori germs (bacteria) may just live harmlessly in the lining of the stomach and duodenum.

What is it called when you have indigestion?

It is sometimes called functional dyspepsia. H. pylori is sometimes found in people with non-ulcer dyspepsia. Getting rid of H. pylori cures some cases but makes no difference in most cases. The cause of most cases of non-ulcer dyspepsia is not known.

Can B12 cause ulcers?

In gastritis the mucous defence barrier appears to be disrupted in some way (and in some cases the amount of acid to be increased). This seems to allow the acid to cause inflammation and ulcers.

What is the purpose of a breath test?

If needed, the breath test or stool antigen test is usually used to check if an infection has cleared following treatment. Sometimes a small sample (biopsy) of the lining of the stomach is taken if you have a gastroscopy (endoscopy). The sample can be tested for H. pylori.

How to treat H pylori?

H. Pylori Treatment Failure 1 About 20% of H. pylori treatment fails after initial treatment. 2 Make sure that the patient is compliant with medications. 3 Since the patient has failed an initial course of treatment, we will use an alternate regimen (triple or quadruple therapy) using a different combination of antibiotics for 14 days. 4 We won’t use Clarithromycin unless we have cultures that show that this H. pylori strain is susceptible to Clarithromycin. 5 Will avoid antibiotics that have been used before. 6 Will consider culture with antibiotic sensitivity testing to guide subsequent treatments if the patient fails the second antibiotic combination. 7 Rx: omeprazole (20 mg BID), tetracycline (500 mg BID), metronidazole (500 mg BID), and bismuth subcitrate caplets (240 mg BID), each given twice daily with the midday and evening meals for 14 days 8 Rx: Florastor to prevent C-diff.

How long does a PPI last?

Levofloxacin (250 mg), amoxicillin (1 g), and a PPI each given twice daily for 14 days. Omeprazole (20 mg), tetracycline (500 mg), metronidazole (500 mg), and bismuth subcitrate caplets (240 mg), each given twice daily with the midday and evening meals for 14 days has been shown to result in a 95% eradication rate.