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Letter
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. 1 Division of Gastroenterology, Department of Medicine, An Nan Hospital, China Medical University, Tainan, Taiwan
  2. 2 Division of Hepato-gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung, Taiwan
  3. 3 Department of Medicine-Gastroenterology, Baylor College of Medicine and Michael E. DeBakey VA Medical Center, Houston, Texas, USA
  4. 4 Department of Environmental and Preventive Medicine, Oita University, Faculty of Medicine, Oita, Japan
  5. 5 Division 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

https://doi.org/10.1136/gutjnl-2022-329253

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    We read the Maastricht VI/Florence consensus report for the management of Helicobacter pylori (H. pylori) infection by Malfertheiner et al 1 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.