amoxicillin + clarithromycin + lansoprazole + metronidazole (National Taiwan University Hospital)

This combination therapy is a sequential treatment regimen for the eradication of Helicobacter pylori infection, a primary cause of peptic ulcers and gastric cancer. Developed and studied by the National Taiwan University Hospital, the regimen typically involves an initial phase of the proton pump inhibitor lansoprazole and the antibiotic amoxicillin, followed by a second phase where clarithromycin and metronidazole are added. Lansoprazole functions by inhibiting the H+/K+ ATPase pump in gastric parietal cells, reducing acid secretion and creating an environment where antibiotics are more stable and effective. Amoxicillin inhibits bacterial cell wall synthesis, clarithromycin blocks protein synthesis by binding to the 50S ribosomal subunit, and metronidazole disrupts bacterial DNA. This multi-drug approach is designed to overcome antibiotic resistance and improve eradication rates compared to standard triple therapy.

Other names

sequential therapy10-day sequential therapy14-day sequential therapy