Clinical utility of tegoprazan in H. pylori eradication strategies

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Created On: 04/02/2026

Tegoprazan, a next-generation potassium-competitive acid blocker (P-CAB), provides rapid and sustained suppression of gastric acid.

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Key take away

A 10-day tegoprazan-based concomitant regimen delivers high H. pylori eradication rates, even in the presence of antibiotic resistance.

Background

Tegoprazan, a next-generation potassium-competitive acid blocker (P-CAB), provides rapid and sustained suppression of gastric acid. This study explored the clinical effectiveness of a tegoprazan-based, non-bismuth quadruple (concomitant) regimen as a first-line therapy for Helicobacter pylori (H. pylori) eradication, particularly in the context of rising antibiotic resistance.

Method

This prospective pilot study evaluated a 10-day tegoprazan-based concomitant treatment for primary H. pylori eradication. The regimen consisted of tegoprazan 50 mg, amoxicillin 1,000 mg, clarithromycin 500 mg, and metronidazole 500 mg, administered twice daily. Antibiotic susceptibility testing and minimum inhibitory concentration analyses were performed via consecutive bacterial cultures.

Result

A total of 84 patients were enrolled, with 79 volunteers (94.0%) completing first-line therapy. The intention-to-treat eradication rate reached 90.5% while the per-protocol eradication rate was 96.2%. Among 73 patients evaluated for antimicrobial resistance, 26% showed clarithromycin resistance, 42.5% exhibited metronidazole resistance, and 11% exhibited dual resistance to both antibiotics. Despite resistance, 66.1% of these patients attained successful eradication with the tegoprazan-based regimen.

Conclusion

A 10-day tegoprazan-based concomitant therapy demonstrated high elimination rates and robust efficacy, even in the presence of antibiotic-resistant H. pylori. These findings support tegoprazan-based quadruple therapy as a promising first-line option for H. pylori infection, offering an effective alternative in regions with increasing antimicrobial resistance.