amoxicillin + tetracycline + bismuth + vonoprazan

This is a four-drug combination therapy consisting of amoxicillin, tetracycline, bismuth, and vonoprazan. It is used primarily for the eradication of Helicobacter pylori (H. pylori) infection. Amoxicillin and tetracycline are antibiotics that inhibit bacterial cell wall synthesis and protein synthesis, respectively. Bismuth compounds have antimicrobial activity against H. pylori and protect the gastric mucosa. Vonoprazan is a novel potassium-competitive acid blocker (P-CAB) that potently inhibits gastric H+,K+-ATPase (the proton pump), resulting in strong suppression of gastric acid secretion[7][10]. This potent acid suppression enhances the efficacy of antibiotics against H. pylori by maintaining an optimal intragastric pH for antibiotic activity[7][10]. The combination targets multiple mechanisms to maximize eradication rates, especially in cases with antibiotic resistance or prior treatment failure.

Other names

VBAT regimenVonoprazan-based bismuth quadruple therapy