esomeprazole + bismuth tripotassium dicitrate + tetracycline + metronidazole + clarithromycin

This therapeutic regimen is a sequential antibiotic therapy developed by National Taiwan University Hospital for the treatment of early-stage Helicobacter pylori-negative gastric mucosa-associated lymphoid tissue (MALT) lymphoma. The treatment protocol begins with a two-week course of bismuth-containing quadruple therapy (BQT)—comprising the proton pump inhibitor esomeprazole, bismuth tripotassium dicitrate, tetracycline, and metronidazole—followed by four weeks of clarithromycin monotherapy. The regimen is based on the clinical observation that a subset of "HP-negative" MALT lymphomas may still be driven by occult H. pylori infection or other antibiotic-sensitive microorganisms. By targeting these potential microbial triggers, the therapy aims to induce complete lymphoma regression, offering a non-chemotherapeutic frontline option for localized gastric MALT lymphoma.

Other names

Bismuth-containing quadruple therapyBQTFrontline HPEFrontline antibiotics therapy