bismuth + cefuroxime + levofloxacin

Bismuth + cefuroxime + levofloxacin is a multi-component antibiotic combination regimen investigated for the eradication of *Helicobacter pylori* infection, specifically in patients with a penicillin allergy. This regimen, often referred to as Cef-Lev BQT, is a research-defined combination consisting of bismuth potassium citrate, the second-generation cephalosporin cefuroxime, and the fluoroquinolone levofloxacin. It is typically co-administered with a proton pump inhibitor (PPI) or a potassium-competitive acid blocker (P-CAB) such as esomeprazole or tegoprazan. The therapy utilizes multiple mechanisms to target the bacteria: cefuroxime inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins, levofloxacin inhibits bacterial DNA replication by targeting DNA gyrase and topoisomerase IV, and bismuth acts as a direct antimicrobial agent. This combination has been evaluated in Phase 4 multicenter randomized controlled trials as a first-line treatment option for penicillin-allergic, treatment-naïve patients.

Other names

cefuroxime-levofloxacin-containing bismuth quadruple therapy