vonoprazan + amoxicillin + tetracycline

This is a combination therapy consisting of three drugs—vonoprazan, amoxicillin, and tetracycline—used for the eradication of Helicobacter pylori infection. - **Vonoprazan** is a potassium-competitive acid blocker (PCAB) that suppresses gastric acid secretion by inhibiting the H+/K+-ATPase enzyme in gastric parietal cells. This potent acid suppression creates an environment conducive to antibiotic activity against H. pylori[1][5]. - **Amoxicillin** is a broad-spectrum beta-lactam antibiotic that inhibits bacterial cell wall synthesis, leading to bacterial death[5]. - **Tetracycline** is a bacteriostatic antibiotic that inhibits protein synthesis by binding to the 30S ribosomal subunit of bacteria[2][3][6]. The rationale for combining these agents lies in maximizing eradication rates by using two antibiotics with different mechanisms alongside strong acid suppression from vonoprazan. While vonoprazan-based regimens are approved and widely studied with amoxicillin (dual therapy) or with amoxicillin plus clarithromycin (triple therapy), combinations involving tetracycline have been investigated primarily as alternatives for patients allergic to penicillin or as part of quadruple therapies; however, triple regimens including all three drugs are not standard but may be considered in certain clinical scenarios where resistance patterns or allergies dictate alternative strategies[1][2][3].