Reviewer ’s report  
 
Title: Management of Helicobacter pylori infections  
 
Version: 0 Date: 29 Jan 2016 
 
Reviewer:  Francesca  Galuppini  
 
Reviewer’s report:  
 
The manuscript is potentially attractive as a Debate article, but there are some c oncerns.  
 
-The Authors have written many times in the manuscript that "only a minority of H Pylori 
infections will cause clinical symptoms screening for H Pylori and subsequent eradication may 
no longer be the best approach" (page 5, lines 24 -26). But most  Countries carry out the screening 
and thus the therapy against H Pylori only in patients with clinical symptoms as epigastralgia, so 
this patients are symptomatic and they require a therapy for their disease, independently of the 
strain or virulence facto r of H Pylori. About that, Figure 1 is not so clear and the Authors could 
implement it.  
 
- The Authors have written, accordingly with the Literature, that H Pylori's virulence depends on 
both viral and host factors. So a strain that in one patients is not a pathogen agent, in another 
patient may cause severe disease and without therapy the infection can spread.  
 
-The different point of views toward H Pylori eradication are discussed in confused way, thus the 
format could be reconsidered.  
 
Are the methods appropriate and well described?  
If not, plea se specify what is required in your comments to the authors.  
 
Unable to assess  
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Unable to assess  
 
Are the conclusions drawn adequately supported by the dat a shown?  
If not, please explain in your comments to the authors.  
 
Unable to assess  
 
Are you able to assess any statistics in the manuscript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further 
assessment in your comments to the editors.  
Not relevant to this manuscript  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some language  corrections before being published  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an 
organisation that may in any way gain or lose financially from the publication of this 
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose 
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the c ontent of the 
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organiz ation that 
holds or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have a ny non -financial competing interests in relation to this paper?  
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below. If your reply is yes to any, please give details below.  
 
I declare that I have no competing interests' below. If your reply is yes to any, please give details 
below  
 
I agree to the open peer review policy of the journal. I understand that my name will be included 
on my report to the authors and, if the manuscript is accepted for publication, my named report 
including any attachments I upload will b e posted on the website along with the authors' 
responses. I agree for my report to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wish to be included in my named report can be included as confidential comments 
to the editors, which will not be published . 
 
I agree to the open peer review policy of the journal  
Reviewer ’s report  
 
Title: Management of Helicobacter pylori infections  
 
Version: 0 Date: 29 Jan 2016 
 
Reviewer:  Francesca  Galuppini  
 
Reviewer’s report:  
 
The manuscript is potentially attractive as a Debate article, but there are some c oncerns.  
 
-The Authors have written many times in the manuscript that "only a minority of H Pylori 
infections will cause clinical symptoms screening for H Pylori and subsequent eradication may 
no longer be the best approach" (page 5, lines 24 -26). But most  Countries carry out the screening 
and thus the therapy against H Pylori only in patients with clinical symptoms as epigastralgia, so 
this patients are symptomatic and they require a therapy for their disease, independently of the 
strain or virulence facto r of H Pylori. About that, Figure 1 is not so clear and the Authors could 
implement it.  
 
- The Authors have written, accordingly with the Literature, that H Pylori's virulence depends on 
both viral and host factors. So a strain that in one patients is not a pathogen agent, in another 
patient may cause severe disease and without therapy the infection can spread.  
 
-The different point of views toward H Pylori eradication are discussed in confused way, thus the 
format could be reconsidered.  
 
Are the methods appropriate and well described?  
If not, plea se specify what is required in your comments to the authors.  
 
Unable to assess  
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Unable to assess  
 
Are the conclusions drawn adequately supported by the dat a shown?  
If not, please explain in your comments to the authors.  
 
Unable to assess  
 
Are you able to assess any statistics in the manuscript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further 
assessment in your comments to the editors.  
Not relevant to this manuscript  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some language  corrections before being published  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an 
organisation that may in any way gain or lose financially from the publication of this 
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose 
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the c ontent of the 
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organiz ation that 
holds or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have a ny non -financial competing interests in relation to this paper?  
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below. If your reply is yes to any, please give details below.  
 
I declare that I have no competing interests' below. If your reply is yes to any, please give details 
below  
 
I agree to the open peer review policy of the journal. I understand that my name will be included 
on my report to the authors and, if the manuscript is accepted for publication, my named report 
including any attachments I upload will b e posted on the website along with the authors' 
responses. I agree for my report to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wish to be included in my named report can be included as confidential comments 
to the editors, which will not be published . 
 
I agree to the open peer review policy of the journal  
Please review this paper.
user
Reviewer ’s report  
 
Title: Management of Helicobacter pylori infections  
 
Version: 0 Date: 29 Jan 2016 
 
Reviewer:  Francesca  Galuppini  
 
Reviewer’s report:  
 
The manuscript is potentially attractive as a Debate article, but there are some c oncerns.  
 
-The Authors have written many times in the manuscript that "only a minority of H Pylori 
infections will cause clinical symptoms screening for H Pylori and subsequent eradication may 
no longer be the best approach" (page 5, lines 24 -26). But most  Countries carry out the screening 
and thus the therapy against H Pylori only in patients with clinical symptoms as epigastralgia, so 
this patients are symptomatic and they require a therapy for their disease, independently of the 
strain or virulence facto r of H Pylori. About that, Figure 1 is not so clear and the Authors could 
implement it.  
 
- The Authors have written, accordingly with the Literature, that H Pylori's virulence depends on 
both viral and host factors. So a strain that in one patients is not a pathogen agent, in another 
patient may cause severe disease and without therapy the infection can spread.  
 
-The different point of views toward H Pylori eradication are discussed in confused way, thus the 
format could be reconsidered.  
 
Are the methods appropriate and well described?  
If not, plea se specify what is required in your comments to the authors.  
 
Unable to assess  
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Unable to assess  
 
Are the conclusions drawn adequately supported by the dat a shown?  
If not, please explain in your comments to the authors.  
 
Unable to assess  
 
Are you able to assess any statistics in the manuscript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further 
assessment in your comments to the editors.  
Not relevant to this manuscript  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some language  corrections before being published  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an 
organisation that may in any way gain or lose financially from the publication of this 
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose 
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the c ontent of the 
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organiz ation that 
holds or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have a ny non -financial competing interests in relation to this paper?  
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below. If your reply is yes to any, please give details below.  
 
I declare that I have no competing interests' below. If your reply is yes to any, please give details 
below  
 
I agree to the open peer review policy of the journal. I understand that my name will be included 
on my report to the authors and, if the manuscript is accepted for publication, my named report 
including any attachments I upload will b e posted on the website along with the authors' 
responses. I agree for my report to be made available under an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wish to be included in my named report can be included as confidential comments 
to the editors, which will not be published . 
 
I agree to the open peer review policy of the journal  
assistant