Helicobacter Pylori Treatment: Dosage Mistakes and Their Impact

Helicobacter pylori

Hello, Doctor: Recently, during a health check-up, I discovered an issue with Helicobacter pylori, so I underwent a self-paid triple therapy regimen at the hospital.
However, I did not carefully check the medication bag and realized that from the first day of treatment on September 16 until now, September 20, I have been taking amoxicillin 500 mg at a dosage of 1 capsule twice a day instead of the prescribed 2 capsules twice a day, resulting in a total of 6 capsules missed.
I would like to ask: 1.
Should I continue taking the original medication along with the other drugs, or should I complete the course of this antibiotic? 2.
Will the incorrect dosage in the initial phase affect the eradication efficacy or lead to antibiotic resistance? I appreciate your help in clarifying these concerns.
Thank you.

Liu Ya, 20~29 year old female. Ask Date: 2020/09/20

Dr. Lin Minghui reply Gastroenterology and Hepatology

Hello, regarding the eradication of Helicobacter pylori, the traditional triple therapy (which includes a proton pump inhibitor and two high-dose antibiotics) is most effective when administered for 10 to 14 days (over 90% success rate).
A 7-day treatment is less effective (below 80% success rate).
One month after completing the treatment, a follow-up appointment can be scheduled to check for successful eradication.
Wishing you peace and health.
Sincerely, Dr.
Ming-Hui Lin, Attending Physician, Department of Gastroenterology, Taoyuan General Hospital, Ministry of Health and Welfare.

Reply Date: 2020/09/20

More Info

When it comes to the treatment of Helicobacter pylori (H. pylori) infection, it is crucial to adhere to the prescribed medication regimen to ensure effective eradication of the bacteria. H. pylori is a common bacterium that can lead to various gastrointestinal issues, including gastritis and peptic ulcers. The standard treatment typically involves a combination of antibiotics and proton pump inhibitors (PPIs) to reduce stomach acid and enhance the effectiveness of the antibiotics.

In your case, you mentioned that you mistakenly took a lower dose of amoxicillin than prescribed. Specifically, you were supposed to take 500 mg twice a day (totaling 1000 mg daily) but only took 500 mg twice a day for a few days, resulting in a total of six missed doses. This situation raises two important questions regarding the continuation of treatment and the potential impact on the effectiveness of the therapy.

1. Should you continue with the original medication regimen or adjust it?
It is essential to follow the advice of your healthcare provider regarding medication adjustments. Generally, if you have missed doses, you should complete the remaining course of antibiotics as prescribed. However, you should not double up on doses to make up for the missed ones. Instead, take the remaining doses as directed. If you have concerns about the missed doses, it is advisable to consult your physician. They may recommend extending the treatment duration or adjusting the regimen based on your specific situation.

2. Will the missed doses affect the eradication of H. pylori or lead to antibiotic resistance?
Missing doses can potentially reduce the effectiveness of the treatment. The success of H. pylori eradication therapy relies on maintaining adequate drug levels in the body to effectively kill the bacteria. Incomplete treatment may not only lead to treatment failure but could also contribute to the development of antibiotic resistance. This is particularly concerning with antibiotics like amoxicillin and clarithromycin, which are commonly used in H. pylori treatment regimens. If the bacteria are not completely eradicated, they may develop resistance to the antibiotics, making future treatments less effective.

In summary, it is crucial to adhere to the prescribed treatment regimen for H. pylori. If you have missed doses, continue with the remaining medication as directed, and consult your healthcare provider for further guidance. They may consider monitoring your response to treatment and possibly conducting follow-up tests to ensure that the infection has been successfully eradicated. Additionally, if you experience any side effects or gastrointestinal discomfort during treatment, such as nausea, abdominal pain, or diarrhea, inform your doctor, as they may need to adjust your treatment plan accordingly.

In conclusion, while mistakes in medication dosing can happen, it is essential to communicate openly with your healthcare provider to ensure the best possible outcome in treating H. pylori infection.

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