Reviewer's report
Title:Beyond Maastricht IV: Are standard empiric triple therapies for Helicobacter
pylori still useful in a South-European country?
Version:3Date:25 September 2014
Reviewer: Enzo Ierardi
Reviewer's report:
The paper of Nuno Almeida et al “Beyond Maastricht IV: Are standard empiric
triple therapies for Helicobacter pylori still useful in a South-European country?”
is a report on the therapeutic success rates of 14-days standard triple therapy in
first-line and 10-day levofloxacin based triple therapy in second-line. Authors
found very disappointing eradication rates for both regimens, and correlated
these results with phenotypic (culture) and genotypic resistances (molecular
biology) and with demographical data by multivariate analysis. Main comments:
• “Group B patients received a median of one eradication 1 (range – 1 to 5)
before inclusion with the following drugs: amoxicillin – 100%; Clarithromycin –
92.2%; Nitroimidazoles – 29.4%”. In those receiving levofloxacin-based triple
therapy, it would be more useful to indicate the previously employed regimens,
not only the previously used drugs.
• “binary logistic regression” should be more appropriately replaced by “binomial
logistic regression”.
• Which mutations in the 23S rRNA gene have been detected for clarithromycin
resistance? It is important to report this detail, as different mutations may imply
different therapeutic outcomes (see De FrancescoV et al, J Med Microbiol, 2014;
De Francesco V et al, Ann Intern Med, 2006).
• Several linguistic mistakes are present
• The discussion is too long, therefore it may annoy the reader. Authors have
discussed some points of their study that are too obvious (such as the fact that
recurrent infections are an independent risk factor for therapy failure), so these
sections can be shortened. Moreover, the reason why clarithromycin resistance
is the main reason for triple therapy failure is poorly discussed (see Giorgio F et
al, World J Gastrointest Pathophysiol, 2013).
Level of interest: An article of importance in its field
Quality of written English: Needs some language corrections before being
published
Statistical review: Yes, and I have assessed the statistics in my report.
Declaration of competing interests:
none declared
Reviewer's report
Title:Beyond Maastricht IV: Are standard empiric triple therapies for Helicobacter
pylori still useful in a South-European country?
Version:3Date:25 September 2014
Reviewer: Enzo Ierardi
Reviewer's report:
The paper of Nuno Almeida et al “Beyond Maastricht IV: Are standard empiric
triple therapies for Helicobacter pylori still useful in a South-European country?”
is a report on the therapeutic success rates of 14-days standard triple therapy in
first-line and 10-day levofloxacin based triple therapy in second-line. Authors
found very disappointing eradication rates for both regimens, and correlated
these results with phenotypic (culture) and genotypic resistances (molecular
biology) and with demographical data by multivariate analysis. Main comments:
• “Group B patients received a median of one eradication 1 (range – 1 to 5)
before inclusion with the following drugs: amoxicillin – 100%; Clarithromycin –
92.2%; Nitroimidazoles – 29.4%”. In those receiving levofloxacin-based triple
therapy, it would be more useful to indicate the previously employed regimens,
not only the previously used drugs.
• “binary logistic regression” should be more appropriately replaced by “binomial
logistic regression”.
• Which mutations in the 23S rRNA gene have been detected for clarithromycin
resistance? It is important to report this detail, as different mutations may imply
different therapeutic outcomes (see De FrancescoV et al, J Med Microbiol, 2014;
De Francesco V et al, Ann Intern Med, 2006).
• Several linguistic mistakes are present
• The discussion is too long, therefore it may annoy the reader. Authors have
discussed some points of their study that are too obvious (such as the fact that
recurrent infections are an independent risk factor for therapy failure), so these
sections can be shortened. Moreover, the reason why clarithromycin resistance
is the main reason for triple therapy failure is poorly discussed (see Giorgio F et
al, World J Gastrointest Pathophysiol, 2013).
Level of interest: An article of importance in its field
Quality of written English: Needs some language corrections before being
published
Statistical review: Yes, and I have assessed the statistics in my report.
Declaration of competing interests:
none declared
Please review this paper.
user
Reviewer's report
Title:Beyond Maastricht IV: Are standard empiric triple therapies for Helicobacter
pylori still useful in a South-European country?
Version:3Date:25 September 2014
Reviewer: Enzo Ierardi
Reviewer's report:
The paper of Nuno Almeida et al “Beyond Maastricht IV: Are standard empiric
triple therapies for Helicobacter pylori still useful in a South-European country?”
is a report on the therapeutic success rates of 14-days standard triple therapy in
first-line and 10-day levofloxacin based triple therapy in second-line. Authors
found very disappointing eradication rates for both regimens, and correlated
these results with phenotypic (culture) and genotypic resistances (molecular
biology) and with demographical data by multivariate analysis. Main comments:
• “Group B patients received a median of one eradication 1 (range – 1 to 5)
before inclusion with the following drugs: amoxicillin – 100%; Clarithromycin –
92.2%; Nitroimidazoles – 29.4%”. In those receiving levofloxacin-based triple
therapy, it would be more useful to indicate the previously employed regimens,
not only the previously used drugs.
• “binary logistic regression” should be more appropriately replaced by “binomial
logistic regression”.
• Which mutations in the 23S rRNA gene have been detected for clarithromycin
resistance? It is important to report this detail, as different mutations may imply
different therapeutic outcomes (see De FrancescoV et al, J Med Microbiol, 2014;
De Francesco V et al, Ann Intern Med, 2006).
• Several linguistic mistakes are present
• The discussion is too long, therefore it may annoy the reader. Authors have
discussed some points of their study that are too obvious (such as the fact that
recurrent infections are an independent risk factor for therapy failure), so these
sections can be shortened. Moreover, the reason why clarithromycin resistance
is the main reason for triple therapy failure is poorly discussed (see Giorgio F et
al, World J Gastrointest Pathophysiol, 2013).
Level of interest: An article of importance in its field
Quality of written English: Needs some language corrections before being
published
Statistical review: Yes, and I have assessed the statistics in my report.
Declaration of competing interests:
none declared
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