esomeprazole + amoxicillin + clarithromycin + colloidal bismuth tartrate

This drug is a fixed-dose combination regimen consisting of four active ingredients: esomeprazole (a proton pump inhibitor), amoxicillin (a beta-lactam antibiotic), clarithromycin (a macrolide antibiotic), and colloidal bismuth tartrate (a bismuth salt). It is used as a first-line or rescue therapy for the eradication of Helicobacter pylori infection. Esomeprazole suppresses gastric acid secretion by inhibiting the H+/K+ ATPase in gastric parietal cells, creating an environment that enhances the efficacy of antibiotics against H. pylori. Amoxicillin and clarithromycin act synergistically to inhibit bacterial cell wall synthesis and protein synthesis, respectively, targeting H. pylori directly. Colloidal bismuth tartrate exerts bactericidal effects on H. pylori and provides mucosal protection by forming a protective barrier over ulcerated tissue[2]. This quadruple regimen is recommended in areas with high rates of antibiotic resistance or after failure of previous eradication therapies.

Other names

esomeprazole-amoxicillin-clarithromycin-bismuthB-quadruple therapy