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A combination treatment regimen consisting of N-acetylcysteine (NAC) followed by culture-guided antibiotics and a proton pump inhibitor (PPI), developed by researchers at the Catholic University of the Sacred Heart for the treatment of refractory Helicobacter pylori infections. NAC, a mucolytic agent and antioxidant, is used as a pretreatment to disrupt the bacterial biofilms formed by H. pylori in the gastric mucosa. By breaking disulfide bonds in mucus glycoproteins, NAC destabilizes the protective biofilm matrix, increasing the susceptibility of the bacteria to subsequent antibiotic therapy. This approach is specifically intended as a rescue therapy for patients who have failed multiple previous eradication attempts and is typically administered as 600 mg of NAC daily for seven days prior to a one-week course of culture-guided antibiotics.
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