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World J Gastrointest Pathophysiol. Aug 15, 2013; 4(3): 43-46
Published online Aug 15, 2013. doi: 10.4291/wjgp.v4.i3.43
Published online Aug 15, 2013. doi: 10.4291/wjgp.v4.i3.43
Primary clarithromycin resistance to Helicobacter pylori: Is this the main reason for triple therapy failure?
Floriana Giorgio, Vincenzo De Francesco, Enzo Ierardi, Division of Gastroenterology, Department of Medical and Surgical Sciences, University of Foggia, 71100 Foggia, Italy
Mariabeatrice Principi, Giuseppe Losurdo, Alfredo Di Leo, Division of Gastroenterology, Department of Emergency and Organ Transplantation, University of Bari, 70124 Bari, Italy
Angelo Zullo, Department of Gastroenterology and Digestive Endoscopy, “Nuovo Regina Margherita” Hospital, 00153 Rome, Italy
Author contributions: De Francesco V, Zullo A, Di Leo A and Ierardi E designed the study, revised the manuscript and approved the final version; Giorgio F and Principi M and Losurdo G collected the data.
Correspondence to: Enzo Ierardi, Professor, Division of Gsatroenterology, Department of Medical and Surgical Sciences, University of Foggia, AOU Ospedali Riuniti, Viale Pinto, 71100 Foggia, Italy. enzo.ierardi@fastwenet.it
Telephone: +39-8-81736204 Fax: +39-8-81733848
Received: May 16, 2013
Revised: June 20, 2013
Accepted: July 4, 2013
Published online: August 15, 2013
Processing time: 84 Days and 20.4 Hours
Revised: June 20, 2013
Accepted: July 4, 2013
Published online: August 15, 2013
Processing time: 84 Days and 20.4 Hours
Core Tip
Core tip: Clarithromycin resistance is the main reason for the failure of conventional therapies for Helicobacter pylori. We evaluate the scope of the problem, as reported in literature and especially on the basis of personal data in adult and paediatric populations. Another issue is the detection of resistance using phenotypic and genotypic methods; comparison is made of the limits and advantages of these approaches. Cost/benefit analysis of unsuccessful eradication therapy is performed. Based on these considerations, the best solution in future seems likely to be the detection of resistant strains before starting treatment.