doxycycline + furazolidone + esomeprazole + colloidal bismuth subcitrate

This combination therapy is a quadruple regimen used as a rescue treatment for *Helicobacter pylori* infection, particularly in patients who have failed multiple previous eradication attempts. It consists of two antibiotics (doxycycline and furazolidone), a proton pump inhibitor (esomeprazole), and a mucosal protective agent (colloidal bismuth subcitrate). Doxycycline and furazolidone work synergistically to inhibit bacterial protein synthesis and interfere with bacterial DNA/enzymes, respectively. Esomeprazole reduces gastric acid secretion to improve antibiotic stability and efficacy, while bismuth provides direct antimicrobial effects and mucosal protection. This specific regimen was evaluated by Sir Run Run Shaw Hospital in a Phase 4 clinical trial (NCT02894268) and found to be superior to tailored therapy based on antibiotic sensitivity.

Other names

Doxycycline- and Furazolidone-containing Quadruple RegimenDF-containing quadruple therapy