metronidazole + bismuth oxide + tetracycline hydrochloride

Metronidazole + bismuth oxide + tetracycline hydrochloride is a fixed-dose combination (FDC) oral therapy developed by Verisfield for the first-line eradication of *Helicobacter pylori* infection. This combination is a variant of bismuth quadruple therapy, which typically includes two antibiotics and a bismuth salt to overcome bacterial resistance, particularly to clarithromycin. Metronidazole is a nitroimidazole antibiotic that acts as a prodrug; upon reductive activation in anaerobic environments, it causes DNA strand breakage and bacterial cell death. Tetracycline hydrochloride is a broad-spectrum antibiotic that inhibits bacterial protein synthesis by binding to the 30S ribosomal subunit. Bismuth oxide provides direct bactericidal activity against *H. pylori*, inhibits bacterial enzymes such as urease, and prevents bacterial adhesion to the gastric mucosa. This FDC is currently being evaluated in Phase III clinical trials in Greece, administered alongside esomeprazole, to assess its efficacy and safety compared to standard non-bismuth concomitant quadruple therapy.

Other names

metronidazole/bismuth oxide/tetracycline hydrochloride