Pylera plus omeprazole: quadruple treatment for Helicobacter pylori

In 2007, the American College of Gastroenterology published updated treatment guidelines for the management of Helicobacter pylori infection, the leading cause of peptic ulcers. The recommended effective therapies are a triple drug regimen for 14 days or a quadruple bismuth therapy for 10 to 14 days, which includes a combination of a proton pump inhibitor such as omeprazole, bismuth, metronidazole, and tetracycline. These drug regimens all require strict adherence and several pills daily, but recent formulations have lessened the pill burden, which can improve patient compliance and outcomes. The pharmacology, product availability, efficacy, and potential adverse reactions of these regimens are discussed in this review.