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**Bismuth subsalicylate + metronidazole + tetracycline** is an oral combination therapy used primarily for the **eradication of Helicobacter pylori** infection in the stomach, typically to treat and prevent recurrence of **duodenal ulcers**. It combines: - **Bismuth subsalicylate** (acts as an antimicrobial and disrupts H. pylori, increases local antibiotic effect), - **Metronidazole** (an antibiotic that damages H. pylori DNA, exerting bactericidal activity), - **Tetracycline** (an antibiotic inhibiting bacterial protein synthesis, preventing growth and multiplication of H. pylori). These agents are synergistic and often used with a fourth drug, a **proton pump inhibitor** (PPI), such as omeprazole, which reduces gastric acidity and enhances treatment efficacy. Brand products include Pylera (capsule formulation) and HELIDAC Therapy (blister pack combination)[1][4][5].
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