esomeprazole + bismuth subsalicylate + metronidazole + tetracycline

H. pylori eradication scheme C is a specific bismuth-containing quadruple therapy regimen used for the eradication of Helicobacter pylori infection. Developed and evaluated by the Unidade Local de Saúde de Coimbra, EPE, this regimen consists of esomeprazole (a proton pump inhibitor), bismuth subsalicylate, metronidazole (a nitroimidazole antibiotic), and tetracycline. The therapy is typically administered over a 10-day period. Esomeprazole acts by inhibiting the gastric H+/K+-ATPase, thereby increasing gastric pH and enhancing the efficacy of the co-administered antibiotics. Bismuth subsalicylate provides direct antimicrobial activity and mucosal protection, while metronidazole and tetracycline target the bacterium through DNA damage and inhibition of protein synthesis (via the 30S ribosomal subunit), respectively. This combination is designed to overcome antibiotic resistance and improve eradication rates in regions with high resistance to clarithromycin.

Other names

Bismuth-containing quadruple therapyH. pylori eradication scheme C-Unidade Local de Saúde de Coimbra, EPE-Helicobacter pylori infection