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Cut-off value of clarithromycin resistance in the treatment of Helicobacter pylori infection: how low is low?
  1. Ping-I Hsu1,
  2. Seng-Kee Chuah2,
  3. Yoshio Yamaoka3,4,
  4. Deng-Chyang Wu5
  1. 1Division of Gastroenterology, Department of Medicine, An Nan Hospital, China Medical University, Tainan, Taiwan
  2. 2Division of Hepato-gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung, Taiwan
  3. 3Department of Medicine-Gastroenterology, Baylor College of Medicine and Michael E. DeBakey VA Medical Center, Houston, Texas, USA
  4. 4Department of Environmental and Preventive Medicine, Oita University, Faculty of Medicine, Oita, Japan
  5. 5Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
  1. Correspondence to Dr Ping-I Hsu, Gastroenterology, An Nan Hospital, China Medical University, Tainan City, Taiwan; williamhsup{at}yahoo.com.tw; Professor Deng-Chyang Wu, No. 100, Tz-You 1st Road, Kaohsiung City 807, Taiwan; dechwu{at}yahoo.com

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We read the Maastricht VI/Florence consensus report for the management of Helicobacter pylori (H. pylori) infection by Malfertheiner et al1 published in the Gut with great interest. The experts addressed that the goal of any antimicrobial therapy is to cure reliably H. pylori infection in the majority (eg, ≥90%) of patients. The goal of cure rate ≥90% meets the expectation of patients in the real-world expectation survey of Asia-Pacific patients for H. pylori eradication therapy,2 which showed 91% of accepted minimal eradication rate expected by H. pylori-infected patients.

In the consensus report, clarithromycin triple therapy is recommended as first-line empirical treatment in areas of low clarithromycin resistance, and low clarithromycin resistance is defined as clarithromycin resistance rate <15%. However, a recent systemic …

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Footnotes

  • Contributors P-IH and D-CW conceived the letter. P-IH, S-KC and D-CW wrote the letter. YY critically reviewed the letter.

  • Funding The study was funded by the An Nan Hospital (Grant Numbers: ANHRF 110-43, ANHRF 111-32 and ANHRF 111-44) and the Ministry of Science and Technology, Executive Yuan, Taiwan, ROC (Grant numbers: MOST 109-2314-B075B-007 and MOST 110-2314-B-039-045).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.