Pylera + amoxicillin + esomeprazole

Pylera + amoxicillin + esomeprazole is a combination drug regimen investigated for the treatment of Helicobacter pylori infection. The regimen consists of Pylera—a fixed-dose combination capsule containing bismuth subcitrate potassium, metronidazole, and tetracycline—administered alongside amoxicillin and the proton pump inhibitor esomeprazole. This multi-drug approach aims to eradicate H. pylori through several mechanisms: bismuth disrupts bacterial cell walls; metronidazole and tetracycline inhibit DNA and protein synthesis; amoxicillin inhibits cell wall synthesis; and esomeprazole reduces gastric acid secretion to optimize antibiotic efficacy. A Phase 4 clinical trial conducted by the American University of Beirut Medical Center (NCT02045251) evaluated a reduced-dose version of this regimen (10 pills per day for 10 days) to improve patient adherence, though the study concluded that the reduced dosage failed to achieve acceptable eradication rates.

Brand names

Pylera

Other names

Reduced-dose Pylera regimen