Which combination of medications is used as first-line treatment for H. pylori infection?

The first-line treatment for Helicobacter pylori (H. pylori) infection typically includes a combination of clarithromycin, amoxicillin, and a proton pump inhibitor (PPI). This approach is effective due to the role of each component in eradicating the bacteria and managing gastric acidity.

Clarithromycin is a macrolide antibiotic that targets the bacterial protein synthesis, leading to the inhibition of H. pylori growth. Amoxicillin, a penicillin antibiotic, works by disrupting the bacterial cell wall synthesis, providing a synergistic effect with clarithromycin. The inclusion of a PPI, such as omeprazole, helps reduce stomach acid production, creating an environment where antibiotics can work more effectively and promoting healing of the gastric lining.

This triple therapy is often chosen for its favorable balance of efficacy, adherence, and tolerability. Over the years, it has been supported by various clinical guidelines as the standard initial therapy to help clear H. pylori infections and prevent associated complications such as peptic ulcers.

Other combinations listed may not have the same level of established efficacy or are not recommended as first-line treatments for H. pylori. For example, ciprofloxacin is typically reserved for other types of infections, and rifamp