Helicobacter pylori management and therapy in 2015"">

Saudi Journal of Gastroenterology

LETTER TO EDITOR
Year
: 2016  |  Volume : 22  |  Issue : 1  |  Page : 81-

Response to: Reply on "Renewed Helicobacter pylori management and therapy in 2015"


Sharmila Fagoonee1, Rinaldo Pellicano2,  
1 Institute for Biostructures and Bioimages (CNR) c/o Molecular Biotechnology Center, University of Turin, Turin, Italy
2 Department of Gastroenterology and Hepatology, San Giovanni Battista (Molinette) Hospital, Turin, Italy

Correspondence Address:
Rinaldo Pellicano
Department of Gastroenterology and Hepatology, San Giovanni Battista (Molinette) Hospital, Turin
Italy




How to cite this article:
Fagoonee S, Pellicano R. Response to: Reply on "Renewed Helicobacter pylori management and therapy in 2015".Saudi J Gastroenterol 2016;22:81-81


How to cite this URL:
Fagoonee S, Pellicano R. Response to: Reply on "Renewed Helicobacter pylori management and therapy in 2015". Saudi J Gastroenterol [serial online] 2016 [cited 2020 Jul 5 ];22:81-81
Available from: http://www.saudijgastro.com/text.asp?2016/22/1/81/173766


Full Text

Sir,

We thank Abadi for his comments on our editorial, [1],[2] that discussed the prospective, randomized, single-blind, controlled study conducted in Shanghai by Wang et al., who compared the efficacy of a 7-day versus a 14-day clarithromycin-based regimen for Helicobacter pylori eradication. [3] Considering the reported strategies aiming to overcome the increasing H. pylori antibiotic resistance, in particular to clarithromycin, [4],[5] Abadi agrees with us that lengthening the treatment from 7 to 14 days confers no significant advantages on eradication rate. We concur with him on the fact that levofloxacin, the fluoroquinolone more often used in the studies involving H. pylori eradication, is the drug that in the short-term should replace clarithromycin. However, we disagree with the author's contention that flouroquinolone-based therapy followed by specific polymerase chain reaction to detect its mutations is a good alternative in clinical practice. We believe that there is no reason to perform this test, when appropriate, after the treatment. Although it is unclear if molecular tests are less expensive than culture-based susceptibility testing, the latter is time consuming and lacks standardization. As the majority of antibiotic resistance mechanisms in H. pylori are restricted to specific point mutations, molecular-based methods offer an attractive alternative. In contrast to culture-based susceptibility assays, these methods are reproducible and easily standardized, as they are independent of cell viability and growth rate of the bacteria. Hence, when available, this could be an interesting approach to guide the treatment.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1Abadi AT. Updated Helicobacter pylori management in 2015. Saudi J Gastroenterol 2016;22:80.
2Pellicano R, Fagoonee S. One or two weeks of treatment with Helicobacter pylori ′′standard′′ triple therapy in the year 2015? Saudi J Gastroenterol 2015;21:343-4.
3Wang J, Zhang G, Hu X, Liu Y, Bao Z, Huang Y. Two-week triple therapy has a higher Helicobacter pylori eradication rate than 1-week therapy: A single-center randomized study. Saudi J Gastroenterol 2015;21:355-9.
4Tursi A, Elisei W, Giorgetti G, Picchio M, Brandimarte G. Decreasing efficacy of the standard seven-day triple therapy containing amoxycillin and clarithromycin in curing Helicobacter pylori infection in clinical setting in Italy: A 10-year follow-up study. Panminerva Med 2014;56:57-61.
5Ribaldone DG, Fagoonee S, Astegiano M, Saracco G, Pellicano R. Efficacy of amoxycillin and clarithromycin-based triple therapy for Helicobacter pylori eradication: A 10-year trend in Turin, Italy. Panminerva Med 2015;57:145-6.