Tetracyclines Bismuth compounds

Two bismuth compounds are available bismuth subsalicylate, a nonprescription formulation containing bismuth and salicylate, and bismuth subcitrate potassium. In the USA, bismuth subcitrate is available only as a combination prescription product that also contains metronidazole and tetracycline for the treatment of H pylori. Bismuth subsalicylate undergoes rapid dissociation within the stomach, allowing absorption of salicylate. Over 99% of the bismuth appears in the stool. Although minimal (< 1%), bismuth is absorbed it is stored in many tissues and has slow renal excretion. Salicylate (like aspirin) is readily absorbed and excreted in the urine. 

Treatment of H. pylori infection typically consists of a combination therapy, using several drugs simultaneously.42 For example, one common form of triple therapy consists of two antibacterials (amoxicillin and clarithromycin) and one of the PPIs described earlier in this chapter.17 36 Alternatively, various quadruple therapies have been used combining bismuth compound (described later in the section on Treatment of Diarrhea ) with a PPI and two antibacterials (e.g., tetracycline and metronidazole).5,36 These drug regimens are typically administered for 1 to 2 weeks and... 

Amoxicillin - Bismuth compounds Clarithromycin Metronidazole - Tetracycline... 

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