Esomeprazole + Colloidal Bismuth Tartrate + Furazolidone + Doxycycline

This is a bismuth-based quadruple therapy regimen used for the eradication of Helicobacter pylori (H. pylori) infection. The combination includes: 1. Esomeprazole - a proton pump inhibitor (PPI) that reduces gastric acid production 2. Colloidal bismuth tartrate - a bismuth salt with antimicrobial properties 3. Furazolidone - an antibiotic effective against H. pylori 4. Doxycycline - a tetracycline antibiotic This quadruple therapy is particularly effective for H. pylori eradication, with studies showing high success rates even in areas with high antibiotic resistance. According to the search results, this specific combination achieved eradication rates of 82.9% by intention-to-treat analysis and 93.7% by per-protocol analysis[1]. The regimen is typically administered for 14 days, though some studies have explored shorter durations for furazolidone (7 days) to reduce side effects while maintaining efficacy[8]. This approach has shown to be both safe and cost-effective, with mild adverse events reported in only about 4.7% of patients[1][6]. This combination is particularly valuable in regions with high clarithromycin resistance, as it provides an alternative to clarithromycin-based triple therapies that have declining effectiveness in many parts of the world[9]. The Maastricht V consensus recommends quadruple therapy with bismuth salts, PPIs and a combination of two antibiotics for H. pylori strains resistant to clarithromycin, metronidazole and fluoroquinolones[9]. The specific dosing typically includes: - Esomeprazole: 40mg twice daily - Colloidal bismuth tartrate: dosage varies by formulation - Furazolidone: 100mg four times daily or 200mg twice daily - Doxycycline: dosage varies by protocol This combination has been studied extensively in China and other regions with high H. pylori prevalence and antibiotic resistance patterns[1][6].

Other names

Bismuth-based quadruple therapy