esomeprazole + amoxicillin + metronidazole

A **combination therapy of esomeprazole, amoxicillin, and metronidazole** is used primarily for the eradication of Helicobacter pylori infection, especially in patients with peptic ulcer disease or gastritis. Esomeprazole is a proton pump inhibitor (PPI) that suppresses gastric acid secretion by inhibiting the H+/K+ ATPase pump in gastric parietal cells, increasing intragastric pH and thus enhancing the stability and efficacy of antibiotics against H. pylori. Amoxicillin is a broad-spectrum beta-lactam antibiotic that inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins, leading to bacterial lysis. Metronidazole is a nitroimidazole antibiotic that is bactericidal against anaerobic bacteria and certain protozoa by causing DNA strand breakage and inhibition of nucleic acid synthesis. This triple combination is particularly effective for overcoming antibiotic resistance and is used as a first-line, second-line, or rescue therapy in H. pylori eradication, depending on local antibiotic resistance profiles and prior treatment failure[2][4][7].