cefuroxime + doxycycline + rabeprazole + bismuth

This is a combination drug consisting of four active pharmaceutical ingredients: - **Cefuroxime** is a second-generation cephalosporin antibiotic that inhibits bacterial cell wall synthesis, effective against a broad range of gram-positive and gram-negative bacteria[1][4]. - **Doxycycline** is a tetracycline-class antibiotic that inhibits protein synthesis by binding to the 30S ribosomal subunit, used for various bacterial infections including those caused by Helicobacter pylori[2]. - **Rabeprazole** is a proton pump inhibitor (PPI) that suppresses gastric acid secretion by inhibiting the H+, K+-ATPase enzyme in gastric parietal cells, aiding ulcer healing and enhancing antibiotic efficacy against H. pylori[3][6]. - **Bismuth** (commonly as bismuth subsalicylate or colloidal bismuth compounds) has antimicrobial activity against H. pylori and provides mucosal protection in the gastrointestinal tract[2][5]. This combination would be expected to act synergistically for eradication of Helicobacter pylori infection and treatment of peptic ulcer disease, similar to established "bismuth quadruple therapy" regimens but with cefuroxime substituted for amoxicillin or metronidazole.