How to take antibiotics for gastritis with high and low acidity: treatment regimen, which ones to take

Why are antibiotics needed?

Antibiotics are a pharmacological group of drugs used to treat infectious diseases caused by protozoan microorganisms, bacteria or fungi.

In gastroenterology, antimicrobial drugs are prescribed to destroy Helicobacter pylori, which infects the stomach and intestines and forms a superficial gray-blue film on the mucous membrane. The vital activity of this strain contributes to the chronicization of pathological processes in the digestive system and the appearance of cancer cells.

The appropriateness of using antibacterial agents is determined by the doctor. You must first undergo a comprehensive examination (endoscopy, stool analysis). A laboratory venous blood test (ELISA) is performed, which detects the presence of antibodies to Helicobacter pylori. They are produced in response to the activity of a pathogen.

If during the research there was the presence of bacteria, antibiotics are prescribed.

Indications for the use of antibacterial drugs are:

• gastritis (chronic, atrophic, antral, erosive, with high or low acidity);
• stomach and duodenal ulcers;
• condition after gastric resection for cancer
• prevention among loved ones and relatives of patients with stomach cancer.

Most often, treatment begins in the acute phase or exacerbation of chronic diseases. Drug therapy aimed at eliminating this strain is called Helicobacter pylori eradication.

Classification of gastritis

Another thing is chronic gastritis, which can be asymptomatic or with mild symptoms, so this pathology can last for years without being noticed. All gastritis is divided into two large categories:

1. Type A is a disease characterized by reduced secretion of hydrochloric acid and occurs against the background of autoimmune problems, when the gastric epithelium, along with the glands that produce gastric juice, is damaged as a result of an attack by its own immune system. This type of disease is considered quite rare, but dangerous due to the high likelihood of developing severe complications, including stomach cancer.
2. Type B – bacterial gastritis caused by the activity of H. Pillory. As a rule, with this form of the disease the acidity of the gastric environment is increased.

Antibiotics for gastritis and stomach ulcers are almost always prescribed, since the most common form of gastritis is bacterial.

Gastritis can be asymptomatic or can cause severe pain

Sluggish chronic gastritis, which is characterized by mild symptoms with a predominance of dyspeptic symptoms, does not require long-term and massive drug therapy. But this condition sooner or later develops into an acute stage, which often requires surgical treatment in a hospital setting.

Antibiotics for erosive gastritis, acute and atrophic forms are indicated in most cases, since these are gastritis with high acidity, provoked by the activity of Helicobacter.

In addition to the antibacterial group, the most common drugs used in the treatment of gastritis are those that reduce the acidity of gastric juice. These are the so-called proton pump blockers, the most prominent representative of which is Omeprazole.

Gastritis is also subdivided according to the place of predominant location of inflammation (antral gastritis) and according to the degree of damage to the mucous membrane in areas of inflammation (erosion, ulcers). In total, there are more than two dozen different types of gastritis, according to the generally accepted Sydney classification, including special forms.

To determine the presence of Helicobacter pylori infection, which will require the inclusion of antibiotics in the gastritis treatment regimen, a mucosal biopsy is performed - a procedure in which pieces of the gastric epithelium are taken for analysis.

List of antibiotics for gastritis

Antibiotics from 4 pharmacological groups are used to treat gastritis:

• Macrolides ( Clarithromycin or Josamycin );
• Semi-synthetic penicillins ( Amoxicillin );
• Tetracyclines ( Tetracycline );
• Other antimicrobial agents ( Metronidazole , Nitrofurel , Furazolidone ).

Therapy is prescribed according to special treatment regimens, which include a complex of antimicrobial drugs.

Antibacterial group of macrolides

The group name of antibiotics is due to their chemical structure (they contain a macrocyclic lactone ring). The mechanism of action is to inhibit protein synthesis in bacteria.

Advantages of the drugs:

• do not cause serious side effects (candidiasis, dysbacteriosis);
• long action;
• wide spectrum (effective against a large number of pathogens);

For the treatment of gastritis caused by the Helicobacter bacteria, semi-synthetic antibiotics are prescribed:

• Clarithromycin (marketed under the names Fromilid , Klacid , Clarbakt, Klabaks , Ecositrin , etc.);
• Josamycin (trade names - Vilprafen and soluble form of Vilprafen solutab ).

Their antimicrobial activity is higher than that of early macrolides.

Josamycin is one of the newest drugs. It differs in the intensity of its action against bacteria that have not yet developed resistance to it. Used as a backup.

Group of penicillin-containing antibiotics

A representative of penicillins is Amoxicillin , a semisynthetic broad-spectrum antibiotic.

Manufactured under the following trade names:

• Flemoxin Solutab;
• Amosin;
• Ecoball.

Often, clavulanic acid is introduced into the dosage form, which prevents the development of resistance in bacteria and prevents the destruction of the antibiotic by enzymes of the microbial cell.

Names of Amoxicillin preparations enhanced with clavulanate:

• Amoxiclav;
• Flemoklav solutab;
• Augmentin;
• Bactoclav;
• Panclave;
• Novoklav;
• Honeyclave;
• Rapiklav;
• Ecoclave.

Types of drugs prescribed

Of course, you need to know which antibiotics can and cannot be taken for gastritis. In addition, it is important to understand the nature of their effect on harmful bacteria and study possible side effects.

• The safest drugs are drugs of the penicillin group. They are natural substances, but modern technologies make it possible to remove penicillin in the laboratory. The drugs are able to penetrate the cell of a harmful bacterium and destroy it from the inside. Due to the relative safety of antibiotics of this group, in severe cases, pregnant women and young children are allowed to take medications for the treatment of gastritis.
• The antibacterial group of macrolides consists of drugs that can destroy the bacterial cell nucleus. The advantage of the medicine is its ability to have an immunostimulating effect on the human body.

• Tetracyclines have a wide spectrum of action. But due to the huge number of side effects, they are prescribed only in cases where treatment with other drugs has proven ineffective.
• Fluoroquinolones are modern drugs with strong effects. They have many contraindications, so they are prescribed exclusively in severe cases.

The course of treatment for gastritis of bacterial origin is developed by the doctor on an individual basis. The doctor always decides how many times a day you need to take the drug.

Metronidazole

Among the new generation of antimicrobial drugs for the treatment of gastritis, Metronidazole is most often used. It is a broad-spectrum antibiotic. The active components of the drug prevent protein synthesis in the cells of harmful bacteria.

Clarithromycin

Clarithromycin belongs to the group of macrolides. It is considered a very powerful modern drug with a broad spectrum of action, so it is imperative to carefully monitor the patient’s condition.

Although, according to statistics, side effects are recorded in only 2% of people taking the drug. Its use is considered most effective in combination with Metronidazole. The duration of taking Clarithromycin should also not exceed a month.

Amoxicillin

Amoxicillin belongs to the penicillin group, which is the safest for the human body. The drug has a wide spectrum of action and can be used in various treatment regimens.

This guarantees the effectiveness of the treatment. To know how to take Amoxicillin, you need to follow the recommendations of the doctor, who individually prescribes a course of treatment. But in any case, you should additionally read the information provided by the instructions for use of the drug.

Rules for taking antibiotics for gastritis

Antibacterial therapy for gastritis is carried out with a combination of antibiotics. The doctor should determine which antibiotics to take for gastritis and their dosage, based on test results.

Antibacterial agents are used:

• strictly on course;
• according to the instructions for use;
• in compliance with the time and number of appointments per day.

Failure to follow these rules leads to bacteria developing resistance to antibiotics. You will have to select stronger drugs and take a second course. And this is not only stress for the body, but also for the wallet - after all, medicines are expensive these days.

Important! Antibiotics are available with a doctor's prescription.

During therapy you must follow the following diet:

• limit the consumption of fatty, heavy, fried, smoked, spicy foods;
• reduce consumption of coffee, strong tea, nicotine, and alcoholic beverages.

Important! Antibiotics are not compatible with alcoholic beverages - this increases the toxic load on the liver and can cause side effects.

When purchasing antimicrobial agents, preference is given to original, high-quality drugs. They differ:

• better purification of raw materials;
• the presence of clinical studies confirming their effectiveness;

The main disadvantage of cheap generics is low bioavailability, which increases the risk of microbial resistance.

A modern view of stomach discomfort

For many years, there was an opinion that gastritis appears only in people who do not follow the principles of a healthy diet, abuse alcohol and nicotine, and take certain groups of medications.

All this could be fair if gastritis did not occur in people in whose lives there were no such causes. The diagnosis was and is made in childhood, in people who carefully monitor their lifestyle and choose healthy foods and the method of preparing them.

The term “gastritis” is a general understanding of a disease that arises in the gastrointestinal tract and causes certain problems to a person. Gastritis is inflammation of the stomach lining.

The pathology can develop over many years and occur in a latent form, when a person does not complain of lack of appetite, pain in the epigastrium after fatty foods, baked goods, or periodic heartburn due to certain foods. An acute attack can occur unexpectedly and, based on the results of the examination, an erosion or ulcer without an intermediate stage of inflammation is diagnosed.

In medicine, there is a gradation of gastritis according to the presence of specific symptoms, localization of inflammation and the reasons for the development of gastrointestinal pathology. There are more than twenty types, but in large-scale format there are two types of gastritis:

1. Bacterial - the cause of inflammation is the bacterium Helicobacter pylori, which develops well in the acidic environment of the stomach and destroys the epithelium of the walls of the digestive organ. The longer the microorganism influences the mucous membrane, the more critical the situation and the brighter the symptoms. But the bacterium can only be detected by performing a gastroendoscopy and taking part of the epithelium for analysis (biopsy).
2. An autoimmune form of gastritis - inflammation of the mucous membrane appears as a result of an attack by the immune system’s own cells on the epithelium of the stomach. The cells and glands of this organ are destroyed and do not produce hydrochloric acid in the required quantity. The process of digesting food is disrupted. This dissonance leads to the formation of cancerous tumors in the stomach. Gastritis of this type is less common than the first, but in medical practice it occurs and requires different therapy than bacterial gastritis.

Inflammation in the stomach begins with a small area, but can gradually develop into erosion or ulceration. The last stage is more difficult to treat, so you should not ignore the symptoms of discomfort in the stomach.

Timely consultation with a doctor allows you to get rid of gastritis completely or put it into remission for a long time.

Treatment regimen for gastritis with antibiotics

There are several options for anti-Helicobacter therapy. They differ in the drugs used and dosages. The treatment regimen depends on the individual characteristics of the patients:

• age;
• body weight;
• presence of chronic diseases;
• hypersensitivity to antibiotics.

In addition to antimicrobial drugs, other drugs are prescribed to treat the digestive system:

• Gastroprotectors (De-nol, Venter, Ulcavis, etc.)
• Proton pump inhibitors (Ultop, Omez, Omeprazole, Nolpaza, Pariet, Nexium, etc.);
• H2-histamines (ranitidine, famotidine).

Contraindications to the use of antibiotics

Each group of antibiotics has its own contraindications, so before using medications you must carefully read the instructions for use.

Almost all groups of antibiotics are contraindicated for use in liver diseases and kidney failure. In addition, it is strictly forbidden to take antibacterial agents if you are individually intolerant to the components that they contain. Gastritis should not be treated with antibiotics in pregnant women and children.

Today, effective treatment regimens for gastritis with antibiotics have been developed. These drugs successfully cope with the causative agent of infection, thereby eliminating the occurrence of relapses of the disease.

It is very important to understand that under no circumstances should you interrupt the prescribed course of treatment on your own. Otherwise, it will not be possible to destroy all harmful bacteria. In addition, some of the surviving bacteria will develop immunity to the drug and for further treatment it will be necessary to develop a new regimen.

It is not allowed to use the product for liver failure, acute gastritis caused by salmonella, and shigellosis.

Clarithromycin is contraindicated in the following cases:

• childhood;
• renal failure;
• liver pathologies;
• hypoglycemia;
• arrhythmia.

You can find out about contraindications to taking other antibiotics prescribed for gastritis by reading the instructions.

Antibiotics for Helicobacter pylori infection

Clarithromycin is approved for use in adults and children from 6 months. Available in tablets, capsules and granules for the preparation of suspension for oral administration. Amoxicillin is used to treat adults and children. Available in the form of tablets, capsules and children's suspension.

Contraindicated for:

• severe infections of the gastrointestinal tract, accompanied by diarrhea and vomiting;
• bronchial asthma;
• allergic diathesis;
• infectious mononucleosis;
• lymphocytic leukemia;
• hay fever;
• viral infections;
• hypersensitivity to penicillins and/or cephalosporins.

For combination with metronidazole:

• diseases of the nervous system;
• hematopoietic disorders;
• hypersensitivity to nitroimidazole derivatives.

When used with clavulanic acid, liver dysfunction and jaundice associated with taking amoxicillin in combination with clavulanate.

Josamycin - produced in tablets. Contraindicated for:

• severe liver pathologies;
• hypersensitivity to macrolides.

Tetracycline - belongs to the group of tetracyclines, available in tablets. Cannot be used:

• children under 8 years old;
• with liver failure;
• for fungal infections;
• during pregnancy and lactation;
• with leukopenia;
• with hypersensitivity to tetracyclines.

Metronidazole is a nitroimidazole derivative. Refers to synthetic antibacterial drugs. Available in dosage forms for external and internal use (tablets, injection solution). Contraindications:

• hypersensitivity;
• leukopenia;
• organic brain lesions;
• epilepsy;
• liver failure (if large doses are prescribed);
• pregnancy (first trimester);
• breastfeeding period.

Nifuratol ( Makmiror ) is an antibiotic from the nitrofuran group. Available in tablets for oral administration. Do not use if you are hypersensitive.

Features of application

Amoxicillin for the diagnosis of gastritis is most often prescribed together with metronidazole, since the treatment regimen for this disease consists of prescribing several drugs that enhance the effect of each other.

You have to make such appointments because during treatment of gastritis, the bacteria can get used to one substance and the treatment will not be effective.

Amoxicillin is taken orally and washed down with plenty of water. The dosage of the drug for the treatment of gastritis together with metronidazole is 1.5 g per day, but the doctor can choose the dose of the drug for the patient individually, taking into account concomitant diseases and the general condition of the patient.

The standard dose of Amoxicillin is 2.25 g for three doses.

Methods of taking antibacterial drugs

Amoxicillin is taken regardless of meals.

Macrolides are taken 2 hours before meals, and Metronidazole and Nifuratol - after meals. Duration of treatment is at least 7 days. If necessary, the course of therapy can be extended.

Important! Antibiotics should not be taken with milk or grapefruit juice. Take it with a glass of water.

Triple therapy method

The primary treatment regimen for gastritis is:

• choice: proton pump inhibitors, ranitidine, or bismuth preparation;
• Amoxicillin 1000 mg capsules or tablets or Metronidazole 500 mg tablets;
• Clarithromycin tablets 500 mg.

A complex of these tablets is taken 2 times a day.

There are combination medications that contain all 3 drugs in one package:

• Pilabakt AM;
• Helitrix;
• Lancid.

Scheme for using quadruple therapy

• gastroprotectors based on bismuth and 500 mg of Tetracycline in tablets - 4 times a day;
• proton pump inhibitors – 2 times a day;
• Metronidazole tablets -500 mg 3 times a day.

other methods

There are different variations of antimicrobial therapy. Here are just a few of them.

• Tetracycline – 500 mg,

Metronidazole (Trichopol) - 400 mg, Bismuth tripotassium dicitrate (De-nol, Ulcavis) - 120 mg, All tablets are taken 4 times a day for 1 week.

• Furazolidone - 200 mg,

Tetracycline – 750 mg, Bismuth preparations – 120 mg.

Duration of therapy – 1 week, 4 doses per day.

• Clarithromycin - 500 mg,

Omeprazole – 40 mg – 2 times a day, Bismuth preparations 240 mg. Take for 7 days 2 times a day.

The most effective drugs

If gastritis is caused by the bacterium Helicobacter pylori, then the most effective remedies are:

• Amoxicillin. This is an antibiotic from the penicillin group. Prescribed in the form of capsules or tablets. This drug can be replaced with products similar in action and composition. These include Flemoxin Solutab, Amoxil, Ecobol, Amoxillat, Amosin.
• Clarithromycin. This medicine belongs to the macrolide series. Analogues are Aziklar, Klatsid, Klareksid, Klamed, Fromilid, Klaritsid, Binoklar, Klabaks.
• Metronidazole. This substance blocks protein synthesis in bacteria, which leads to a decrease in their activity and reproduction. Produced in tablet form.

These are the best antibiotics for gastritis of any form; they provide the lowest risk of adverse reactions.

Less popular antibiotics may include the following:

• Tinidazole;
• Hiconcil;
• Helicocin;
• Metronidazole-Nycomed;
• Erythromycin;
• Pilobact;
• McMimorr.

In some cases, it is possible to use tetracycline antibiotics. Azithromycin or Levofloxacin is also sometimes prescribed.

Possible complications and side effects

Eradication therapy involves the use of high doses of antibiotics.

Main side effects:

• Disturbance of intestinal microflora. It manifests itself as flatulence, bloating, causeless pain in the intestines, diarrhea or constipation.

To avoid this, eubiotics are taken in parallel with antibacterial drugs - Bifiform, Linex, Acipol;

• Candidiasis (thrush) – develops due to an imbalance of flora. Eliminated by the use of Fluconazole or Nystatin according to the regimens specified in the instructions;
• Allergic reactions, because antibiotics are strong allergens. If symptoms occur, take antihistamines.

Compliance with the rules of therapy can reduce the likelihood of negative consequences.

Use of antibiotics for gastritis during pregnancy

The use of antibiotics is strictly contraindicated in the first trimester of pregnancy, when all organ systems are forming. Antibiotics disrupt intrauterine development.

According to the instructions, it is allowed to use most of these funds starting from the second trimester. However, in order to avoid harmful effects on the child's body, it is recommended to postpone antimicrobial therapy until the postpartum period.

Antibiotics are not used during breastfeeding. If necessary, breastfeeding is suspended and continued after taking medications.

Overdose

If recommended dosages are followed, side effects are rare.

Symptoms of overdose are:

• loose stools;
• nausea and vomiting;
• electrolyte imbalance;
• abdominal pain;
• dehydration.

Treatment of overdose:

• gastric lavage;
• the use of sorbents (Enterosgel, Polysorb, Smecta, White Coal, Filtrum-STI, Laktofiltrum, Polyphepan, etc.);
• saline solutions (Regidron, Gidrovit).

special instructions

Amoxicillin can be prescribed during pregnancy, but only if the benefit to the mother outweighs the risk to the fetus. During the period of breastfeeding, you can use an antibiotic, but then you should temporarily abandon natural feeding.

Before starting to use the medicine, you need to make sure that the patient is not allergic to the substances contained in the medicine.

Amoxicillin and alcohol are incompatible concepts. When carrying out antibiotic therapy, you need to give up alcohol. Otherwise, the liver can become severely damaged, and sometimes a malignant tumor can even develop in this organ.

Taking strong drinks not only has a detrimental effect on the liver, but also reduces the effect of Amoxicillin, disrupts the concentration of the drug in the blood, increases the load on the liver, which can lead to tissue necrosis.

Interactions with other drugs

The combined use of antibiotics from different groups mutually enhances their antimicrobial activity. The administration of antimicrobial agents enhances the gastroprotective effect of bismuth preparations and antiulcer agents.

Painkillers and anti-inflammatory drugs increase the concentration of antibiotics and the duration of their action. Antimicrobial drugs reduce the effectiveness of estrogen-containing oral contraceptives. More detailed information on each medicine is provided in the instructions for use.

Amoxicillin with Metronidazole: when should you take it?

Gastritis does not always need to be treated with the antibiotic Amoxicillin. After all, this disease can be caused by improper (harmful) nutrition, the effects of alcohol, and medications. But if the bacterium Helicobacter pylori gets into the stomach, and it gets there with poor-quality food, then the only way to destroy it is to use an antibiotic.

Often, gastroenterologists prescribe 2 groups of antibacterial agents to patients at once - Amoxicillin and Metronidazole. Many people wonder why you need to take two antibiotics at the same time?

The fact is that the Helicobacter pylori bacterium quickly gets used to antibacterial agents and stops responding to them. In order for the treatment to really produce results, doctors prescribe two drugs at once. Both means complement each other.

You need to take medications 1.5–2 grams twice a day. But the treatment regimen can be changed by the doctor. It takes into account the patient’s health status, the severity of the disease, the effectiveness of treatment and its duration.

Gastritis, which is not caused by the bacterium Helicobacter pylori, requires different treatment. Antibiotics will not work in this case.

Amoxicillin and Metronidazole are most often used in tablet form. When treating tuberculosis, the use of a combination of these drugs in patients under 18 years of age with gastrointestinal or liver diseases is not recommended.

When treating patients with diabetes, the presence of sucrose in medications must be taken into account. There is some peculiarity of influence on the ability to control complex, potentially dangerous mechanisms or vehicles.

When treating gastritis, use 1 tablet of each drug orally three times a day for 12 days. For the treatment of tuberculosis, as an additional measure, the course of treatment is extended to an average of 6 months. If kidney function is impaired, the dosage is reduced. The maximum daily dose should not exceed 2 grams of each drug.

Amoxicillin should be taken before meals, and Metronidazole after. You need to take the tablets with water or milk. During treatment with these drugs, drinking alcoholic beverages is strictly prohibited.

The use of products for allergic diseases and hypersensitivity to beta-lactam antibiotics is not recommended.

At the moment, the only drug that can treat tuberculosis in children is amikacin, a 3rd generation aminoglycoside. This is due to its minimal toxicity. Can be used by children over 1 year old.

Due to the fact that the drug is poorly absorbed when used orally, it is prescribed as intramuscular or intravenous injections.

Possible side effects

Side effects from taking both drugs at the same time are no different than if they were used separately. In some cases, the following reactions occur:

• from the digestive system: diarrhea, nausea, vomiting;
• allergic reactions;
• teturam-like effect.

The following violations may occur:

With such a large list of side effects, sleep disturbances and fatigue are often observed.

Efficiency of application

Due to the fact that the drugs enhance each other’s actions, we can confidently speak about their effectiveness. But in each specific case, the relevance of treatment with these particular drugs should be considered individually, taking into account all the features of the course of the disease.

In most cases, this complex is indispensable for those patients for whom other drugs are contraindicated or when these drugs do not provide the desired effect.

Reviews

According to patient reviews, modern antibacterial drugs are well tolerated and do not cause severe side effects. When using them, diarrhea and constipation are most often observed.

The disadvantages include:

• high cost of a course of anti-Helicobacter therapy;
• the need to use other drugs;
• Sometimes repeated doses of antibiotics are required.

Doctors note the high effectiveness of antibiotics. However, they express concern that patients often buy cheap generic drugs, after which they have to be prescribed backup therapy using stronger and more expensive drugs.

Amosin and Amoxicillin: can one be replaced by the other?

People often encounter situations where, when buying drugs at a pharmacy, pharmacists offer analogues, noting that there is no such drug with the same name, but there is a substitute. The same thing happens with Amoxicillin tablets. They are often replaced with another medicine - Amosin tablets.

Is there a difference between these drugs and if so, what is it?

• Both drugs contain the same active substance - amoxicillin trihydrate;
• The regimen and dosage for both medications are the same;
• Indications, contraindications, and side effects for the drugs are the same, because the composition of the drugs is identical.

There is no difference between Amosin and Amoxicillin. They are sold under different names, but are interchangeable. Both drugs are in the same price segment.

Antibacterial therapy regimens

If Helicobacter pylori is diagnosed during the examination, several groups of medicinal substances are prescribed for etiological and pathogenetic therapy. Antibiotics for gastritis and stomach ulcers are first-line drugs that are used against pathogenic pathogens. Antibacterial agents are prescribed in parallel with other medications. This approach allows you to quickly relieve the symptoms of the disease and reduce the likelihood of relapse of infection, and potentiate the effect of antibiotics.

Antibiotic regimens for gastritis and ulcers differ in the type of antibacterial substance, the number of drugs, and the duration of the course. The protocol includes the following treatment options:

1. Three-component - first line.
2. Three-component with a history of an allergic reaction to the penicillin series of antibiotics.
3. Consistent.
4. Quadruple therapy is second line.
5. "Salvation" scheme.

Important! Medicines must be taken before meals. Otherwise, it is difficult to create the concentration of drugs in the blood plasma necessary for the elimination of Helicobacter pylori.

The transition from one treatment regimen to another is carried out sequentially if the previous one was ineffective. Antibiotic replacement is performed only by a specialist according to the protocol, taking into account the indications and contraindications for a particular patient.

Triple therapy and its essence

The first stage of treatment for inflammatory diseases of the digestive tract associated with Helicobacter pylori infection is the prescription of a combination of three drugs. The regimen includes antibiotics for the treatment of gastritis or stomach ulcers, as well as proton pump inhibitors. Information on how to take them correctly is reflected in Table 1.

Table 1. Triple therapy regimen