bismuth + clarithromycin + tinidazole

This is a combination therapy consisting of three agents—bismuth, clarithromycin, and tinidazole—used primarily for the eradication of Helicobacter pylori (H. pylori) infection. Bismuth acts as a mucosal protective agent with some antimicrobial activity against H. pylori; clarithromycin is a macrolide antibiotic that inhibits bacterial protein synthesis by binding to the 50S ribosomal subunit; and tinidazole is a nitroimidazole-class antibiotic effective against anaerobic bacteria and protozoa by causing DNA strand breakage and loss of helical structure. This combination may be used as part of triple or quadruple therapy regimens, often alongside acid-suppressing agents such as proton pump inhibitors or H2-receptor antagonists, to increase eradication rates in peptic ulcer disease associated with H. pylori infection[1][8]. The regimen aims to overcome resistance patterns seen with single-agent therapies.