The efficacy of antibiotic therapy for Helicobacter pylori is highly variable in the world. It depends on bacteriological, environmental and host factors. First- line antibiotic drug-resistance is increasingly seen in some regions of the world. Every time the introduction of new therapeutic schemas are necessary for overcome this problem. According to your personal experience what is the best antibiotic therapy schema in you practice and what is your protocol for confirming eradication? Best regards to everybody
As you said antibiotics therapy for H.pylori is very different in different countries.
Nice question about being sure of eradication.
Lab tests include RUT, UBT, Serology, PCR and culture.
Just Imagine, there is many reports of colonization of this bacteria on mouth for example and some case reports about another bacteria cuz of false positive of UBT and so on.
Therefore I think it's really hard to say eradication about this bacteria.
Regards
Dear Alireza
In pragmatic medical practice, a protocol of H pylori eradication is mandatory; it is based on cost and risk- effectiveness rate. In Iran as in many countries of the world I think the use of C13 or C14 breath tests are used with this objective. Is it right?
Yes, it's right.
Because of high frequency of infection in some part of country, docs use RUT test also.
Regards
For RUT is it necessary to perform and endoscopy. Is it used in some areas of Iran for Hp erradication?
Recently I have started using a specific strain of Lactobacillus available in clinical practice by LUPIN
Pyloflush 100 mg twice daily for 4 weeks
Results seems acceptable 70 to 80 % even without antibiotics
Dear Ligen Yu
Thanks for your article. I must say that I do not have experience with the use of probiotics for the treatment of H pylori. Nevertheless, there are many studies concerning this issue. It seems that some strains are most active against this microbe. The right combination and type of stains on probiotics most effective against H pylori is not clear, nevertheless I accept that this treatment choice must be seriously considered for some cases of H pylori infection. Maybe the combination of these agents with antibiotics may increase efficiency.
Best regards
Dear Prof Diego, thanks for your reply. Yes, you are right, the combination of probiotic agents with antibiotics may increase the efficiency. In fighting with any type of pathogens, there are always two approachs: kill the pathogens or enhance the resilience of our body to the pathogens. Antibiotics belong to the first approach, and I suspect that fermented foods belong to the second approach. Fermented foods provide unique nutrients like enzymes to our stomach to rebuid the integrity of our stomach linings, so that it becomes unassailable to H-pylori.
Best regards
Dear Diago
RUT needs endoscopy and all over Iran docs use this method not just for H.pylori, but if there is metaplasia in stomach, they offer once per year doing endoscopy after antibiotics therapy.
Regards.
Alireza
The question for you was. Do physcicians in Iran use RUT for confirming erradication of H pylori?
Regards
Greetings from Greece! First choice in greece is: Amoxicillin 1gr s:1 x 2, clarithromycin 500mg s:1x2, metronidazole 500 s:1x2, Omeprazole 20mg s:1x2 for 10 days (both tetracycline and bismuth are not available in my country). Eradication (or not) is confirmed with helicobacter breath test INFAI
Dear Prof Diego García-Compeán , given the low virulence of Helicobacter pylori and the high prevalence of its infection worldwide, it might be the time to regard it as a commensal organism, not treat it a pathogen:
Article Helicobacter pylori the Latent Human Pathogen or an Ancestra...
The medicines used for the eradication of H. pylori will inevitably kill other commensal organisms in the human microbiome, which might have adverse effect on our health.
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