Antibiotic Pills & Drugs

Question:

My mother 75, is having severe side effects to the precribed meds. for H-Pylori infection. She was taken off Flagel which caused severe side effects. Currently on Leviquin and Bioxin which are also giving her severe side effects (she was seen in the emgergency room this morning and released) Her doctor said to continue with these meds. but to cut the doses in half. Is this common? I there any other treatment for one with such senitivity? She`s never been one to complain, yet she says she would rather die than feel the effects of these antibiotics. Help!

Answer:

The American College of Gastroenterology (ACG) recommends the following triple drug therapy as initial treatment for H. pylori:

1. A proton pump inhibitor such as omeprazole (Prilosec is a common brand) 

2. Clarithromycin 500mg (Biaxin is a common brand) twice daily 

3. Amoxicillin 1000mg twice daily or metronidazole (Flagyl) 500mg twice daily

A minimum of seven days of therapy is advised.  If the above therapy fails, the following is recommended by the ACG:

1. Bismuth subsalicylate 525mg four times daily (Pepto Bismol)

2. Metronidazole 500mg three times daily  (Flagyl) 

3. Tetracycline 500mg four times daily

4. A proton pump inhibitor daily or twice daily (Prilosec)

Therapy ranges from seven to fourteen days.  Reducing doses of antibiotics can lead to treatment failure.  Antibiotic doses which are too low to harm the bacteria can help the bacteria to become resistant to that particular antibiotic.

Persons on drug therapy with antibiotics for H. pylori often experience stomach problems as a side effect of therapy.  The side effects are temporary and should end when the therapy is finished.

Levofloxacin (Levaquin) based therapy for H. pylori is generally reserved for failures with the above drugs or when patients cannot tolerate the second-line 4 drug therapy noted above.

(Reference: Pharmacist's Letter; 2006; 22(5):220512)