Highlighting dual-therapy-based Helicobacter pylori eradication (Single antibiotic with acid reducer is best)

Medical Xpress / Cactus Communications / Chinese Medical Journal ^ | March 14, 2023 | Miao Duan et al

[ConservativeMind]

Helicobacter pylori (H. pylori) is an infectious bacterium can cause chronic gastritis, peptic ulcers, and iron deficiency anemia. If left untreated, it can also lead to the development of stomach cancer.

Recently, researchers from China conducted an exhaustive review of the clinical trajectories of various treatments (e.g., bismuth-containing quadruple therapy (BQT), dual therapy (DT), and standard triple therapy) that have historically been used to combat H. pylori infection.

The research team retrieved studies on PubMed.

…A German study in 1993 was more promising. Clinicians administered 20 mg omeprazole twice a day (bid) and 500 mg amoxicillin four times a day (qid) to patients for 14 days. The eradication rate of H. pylori increased to 78.9%, and, the healing rate of duodenal ulcers was 100%.

In 1995, when clinicians increased the dose of amoxicillin to 750 mg (thrice a day; tid) and that of omeprazole to 40 mg (tid), they observed a 91% eradication of H. pylori infection in patients with duodenal ulcers.

Recent developments have shown significant promise. For instance, a meta-analysis based on 41 randomized controlled trials (RCTs) involving 14,119 patients showed that 14-day high-dose DT (concomitant high-frequency administration of at least one acid suppressor and 3,000 mg of amoxicillin) has good efficacy and patient compliance and few adverse events.

According to the review, amoxicillin is the most preferred antibiotic in DT owing to several reasons such as ultra-low H. pylori resistance rate, fewer adverse effects, and optimal excretion.

First-generation PPIs such as omeprazole are now being replaced with more efficacious second-generation PPIs, such as esomeprazole and rabeprazole. Furthermore, based on a 2022 meta-analysis including 668 patients with H. pylori infection and a few other studies, clinicians are also recommending the use of a combination of vonoprazan and amoxicillin (VA-DT) for a period of 14 days.

[ConservativeMind]

There’s no reason to have H. pylori and going from three types of antibiotics to one makes a lot of sense, as it will destroy fewer types of gut bacteria we need.

Various acid reducers and antibiotics are described for the dual therapy option, within the write up.

[ConservativeMind]

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[ProtectOurFreedom]

I had H. pylori for years and it was awful. My doc was useless and it took me doing my own research to tell him we needed to look for it. He said “that makes sense” and ordered the test which came back positive. He prescribed the triple therapy which eradicated it.

That doc was useless on that problem and again on COVID. He left the clinic not long ago.

[al baby]

I had it once also did the 3 step thing too took about a month to get rid of it

[Sparticus]

I never had any tests but had all the symptoms of H.pylori for over a year. After a couple of months of taking zinc L-carnosine supplements plus apple cider vinegar, my symptoms are 95% gone. Previously, I had been using antacids but am off those entirely now.

[Delta 21]

When my turn came up I started 1000mg Black Currant Seed oil. It was cleared up in less than a month and I finished the bottle and that was it. This was 15 years ago.