bismuth subcitrate potassium + metronidazole + tetracycline hydrochloride + omeprazole

A quadruple therapy regimen combining three antibacterial agents (bismuth subcitrate potassium, metronidazole, and tetracycline hydrochloride) with a proton pump inhibitor (omeprazole) for the treatment of Helicobacter pylori infection and duodenal ulcer disease. The three antibacterial components are typically administered as a combination product (Pylera), while omeprazole is administered separately. This regimen works through multiple mechanisms: bismuth disrupts H. pylori and enhances antibiotic effects, metronidazole damages bacterial DNA, tetracycline inhibits bacterial protein synthesis, and omeprazole reduces stomach acid to create a more favorable environment for the antibiotics to work. This combination is particularly effective as a rescue therapy for patients who have failed previous H. pylori eradication attempts.

Brand names

Pylera

Other names

quadruple therapybismuth quadruple therapy