Reviewer's report
Title:High efficacy in Helicobacter pylori retreatment: seven days with
furazolidone, levofloxacin and lansoprazole, in Sao Paulo, Brazil.
Version: 2Date:21 November 2008
Reviewer: V Ahuja
Reviewer's report:
This is a well conducted study which looks at the efficacy and tolerability rates of
a furazolidone salvage therapy . This may be a pertinent question to be
answered as the number of H.pylori eradication failures are on the rise in
developing countries. Hence there is a need to test various salvage therapies
which are not affected by metronidazole as we as clarithromycin resistance .
Major problems with this study :
<!--[if !supportLists]-->1. <!--[endif]-->Antibiotic sensitivity tests on gastric
biopsies have not been conducted .
<!--[if !supportLists]-->2. <!--[endif]-->The sample size is not large
The authors need to discuss these two major limitations of this study in the
Discussion section.
Minor problems :
<!--[if !supportLists]-->1. <!--[endif]-->It is not clear as on what basis the
investigators decided to give the therapy for 7 days and not ten days or 14 days .
The investigators should discuss the previously published literature on
furazolidone based therapies and the impact of therapy duration.
<!--[if !supportLists]-->2. <!--[endif]-->It would be interesting to know what was the
status of urease based tests versus histology in determining eradication status
As eradication status was defined as 2of 3 tests negative . Is it possible that
eradication rates were overestimated in case there was a skew of urease based
tests being negative as opposed to histology ? This is a well described
phenomenon which may occur particularly in situations where H.pylori density is
low.
<!--[if !supportLists]-->3. <!--[endif]-->Table 6 should be described in greater
detail in Results section
<!--[if !supportLists]-->4. <!--[endif]-->Table 5 may be deleted
<!--[if !supportLists]-->5. <!--[endif]-->Table 2 : the activity scale has not been
mentioned in methods section
Reviewer's report
Title:High efficacy in Helicobacter pylori retreatment: seven days with
furazolidone, levofloxacin and lansoprazole, in Sao Paulo, Brazil.
Version: 2Date:21 November 2008
Reviewer: V Ahuja
Reviewer's report:
This is a well conducted study which looks at the efficacy and tolerability rates of
a furazolidone salvage therapy . This may be a pertinent question to be
answered as the number of H.pylori eradication failures are on the rise in
developing countries. Hence there is a need to test various salvage therapies
which are not affected by metronidazole as we as clarithromycin resistance .
Major problems with this study :
<!--[if !supportLists]-->1. <!--[endif]-->Antibiotic sensitivity tests on gastric
biopsies have not been conducted .
<!--[if !supportLists]-->2. <!--[endif]-->The sample size is not large
The authors need to discuss these two major limitations of this study in the
Discussion section.
Minor problems :
<!--[if !supportLists]-->1. <!--[endif]-->It is not clear as on what basis the
investigators decided to give the therapy for 7 days and not ten days or 14 days .
The investigators should discuss the previously published literature on
furazolidone based therapies and the impact of therapy duration.
<!--[if !supportLists]-->2. <!--[endif]-->It would be interesting to know what was the
status of urease based tests versus histology in determining eradication status
As eradication status was defined as 2of 3 tests negative . Is it possible that
eradication rates were overestimated in case there was a skew of urease based
tests being negative as opposed to histology ? This is a well described
phenomenon which may occur particularly in situations where H.pylori density is
low.
<!--[if !supportLists]-->3. <!--[endif]-->Table 6 should be described in greater
detail in Results section
<!--[if !supportLists]-->4. <!--[endif]-->Table 5 may be deleted
<!--[if !supportLists]-->5. <!--[endif]-->Table 2 : the activity scale has not been
mentioned in methods section
Please review this paper.
user
Reviewer's report
Title:High efficacy in Helicobacter pylori retreatment: seven days with
furazolidone, levofloxacin and lansoprazole, in Sao Paulo, Brazil.
Version: 2Date:21 November 2008
Reviewer: V Ahuja
Reviewer's report:
This is a well conducted study which looks at the efficacy and tolerability rates of
a furazolidone salvage therapy . This may be a pertinent question to be
answered as the number of H.pylori eradication failures are on the rise in
developing countries. Hence there is a need to test various salvage therapies
which are not affected by metronidazole as we as clarithromycin resistance .
Major problems with this study :
<!--[if !supportLists]-->1. <!--[endif]-->Antibiotic sensitivity tests on gastric
biopsies have not been conducted .
<!--[if !supportLists]-->2. <!--[endif]-->The sample size is not large
The authors need to discuss these two major limitations of this study in the
Discussion section.
Minor problems :
<!--[if !supportLists]-->1. <!--[endif]-->It is not clear as on what basis the
investigators decided to give the therapy for 7 days and not ten days or 14 days .
The investigators should discuss the previously published literature on
furazolidone based therapies and the impact of therapy duration.
<!--[if !supportLists]-->2. <!--[endif]-->It would be interesting to know what was the
status of urease based tests versus histology in determining eradication status
As eradication status was defined as 2of 3 tests negative . Is it possible that
eradication rates were overestimated in case there was a skew of urease based
tests being negative as opposed to histology ? This is a well described
phenomenon which may occur particularly in situations where H.pylori density is
low.
<!--[if !supportLists]-->3. <!--[endif]-->Table 6 should be described in greater
detail in Results section
<!--[if !supportLists]-->4. <!--[endif]-->Table 5 may be deleted
<!--[if !supportLists]-->5. <!--[endif]-->Table 2 : the activity scale has not been
mentioned in methods section
assistant