Cut-off value of clarithromycin resistance in the treatment of Helicobacter pylori infection: how low is low?

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 review for randomised controlled trials published between 1 January 2011 and 1 January 2022 showed that the per-protocol eradication rates of 14-day clarithromycin...
Source: Gut - Category: Gastroenterology Authors: Tags: Gut PostScript Source Type: research