esomeprazole + clarithromycin + metronidazole

A fixed-dose combination of esomeprazole, clarithromycin, and metronidazole is used as a triple therapy regimen for the eradication of Helicobacter pylori infection. Esomeprazole is a proton pump inhibitor that suppresses gastric acid secretion by inhibiting the Gastric H+/K+ ATPase in gastric parietal cells, thereby increasing intragastric pH and enhancing the efficacy of antibiotics against H. pylori. Clarithromycin is a macrolide antibiotic that inhibits bacterial protein synthesis by binding to the Bacterial 50S ribosomal subunit. Metronidazole is an antimicrobial agent effective against anaerobic bacteria and protozoa; it disrupts DNA synthesis in susceptible organisms. This combination therapy targets H. pylori through complementary mechanisms—acid suppression (esomeprazole) and direct antibacterial effects (clarithromycin and metronidazole)—and is primarily indicated for patients with peptic ulcer disease or dyspepsia associated with H. pylori infection[1][2].