Quadruple Therapy for Gastric Ulcers: What Medications Are Used

Understanding Quadruple Therapy

The standard quadruple therapy for gastric ulcers consists of four medications – one proton pump inhibitor (PPI), two antibiotics, and one bismuth compound. This treatment approach is highly effective in eliminating Helicobacter pylori (H. pylori), a common cause of peptic ulcers.

1. Proton Pump Inhibitors (PPIs)

Proton pump inhibitors play a key role in reducing stomach acid production, allowing the ulcer to heal properly. Commonly prescribed PPIs include Omeprazole, Rabeprazole, and Esomeprazole. These medications are typically taken twice daily, before meals, to maximize their effectiveness.

2. Antibiotics: Dual Action Against H. Pylori

To effectively combat bacterial infection, two antibiotics are used together. The most commonly recommended combination includes Amoxicillin and Clarithromycin. Amoxicillin is favored due to its high efficacy and low resistance rates, especially in regions like China. Clarithromycin, a macrolide antibiotic, works synergistically with Amoxicillin for optimal results.

This dual antibiotic regimen usually lasts between 10 to 14 days. However, if a patient is allergic to either Amoxicillin or Clarithromycin, alternative options such as Metronidazole, Tinidazole, or Ornidazole can be considered. In some cases, fluoroquinolone antibiotics may also be used as substitutes depending on individual medical history and regional resistance patterns.

3. Bismuth Compounds: Protective and Antimicrobial Effects

Bismuth-based medications like De-Nol (Colloidal Bismuth Subcitrate) or Sanjiu Weitai are included in the quadruple therapy regimen due to their protective coating properties and antimicrobial activity against H. pylori. These compounds help soothe the stomach lining while enhancing the overall effectiveness of the treatment.

Effectiveness of Quadruple Therapy

When followed correctly, this four-drug combination has a success rate of approximately 70% to 80% in eradicating H. pylori and healing ulcers within 10 to 14 days. Completing the full course of medication as prescribed is crucial to ensure successful treatment and prevent recurrence.

By following this structured quadruple therapy, patients can significantly improve their chances of complete ulcer recovery while minimizing long-term complications. Always consult with a healthcare professional before starting any treatment plan.