omeprazole + rabeprazole + clarithromycin + amoxicillin

This is a combination therapy consisting of two proton pump inhibitors (omeprazole and rabeprazole) and two antibiotics (clarithromycin and amoxicillin). Both omeprazole and rabeprazole act by inhibiting the gastric H+/K+ ATPase enzyme, thereby reducing stomach acid production. Clarithromycin is a macrolide antibiotic that inhibits bacterial protein synthesis, while amoxicillin is a penicillin-class antibiotic that inhibits bacterial cell wall synthesis. The primary indication for this combination would be the eradication of Helicobacter pylori infection to treat or prevent peptic ulcers. While triple therapies using either omeprazole or rabeprazole with clarithromycin and amoxicillin are well-established, there is no standard regimen combining both PPIs simultaneously; such use would be highly unusual in clinical practice[1][2][3][6]. Each component has been shown to contribute to high rates of H. pylori eradication when used as part of standard triple therapy.