Editorial
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Sep 21, 2017; 23(35): 6379-6384
Published online Sep 21, 2017. doi: 10.3748/wjg.v23.i35.6379
Resistance to clarithromycin and gastroenterologist’s persistence roles in nomination for Helicobacter pylori as high priority pathogen by World Health Organization
Amin Talebi Bezmin Abadi
Amin Talebi Bezmin Abadi, Department of Bacteriology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran 14115, Iran
Author contributions: Amin TBA collected the primary data and designed the first draft and finally wrote the manuscript.
Conflict-of-interest statement: No potential conflicts of interest relevant to this article were reported.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Amin Talebi Bezmin Abadi, PhD, Department of Bacteriology, Faculty of Medical Sciences, Tarbiat Modares University, P.O. Box 111, Tehran 14115, Iran. amin.talebi@modares.ac.ir
Telephone: +98-21-82884883 Fax: +98-21-82884883
Received: July 3, 2017
Peer-review started: July 4, 2017
First decision: July 28, 2017
Revised: August 6, 2017
Accepted: August 25, 2017
Article in press: August 25, 2017
Published online: September 21, 2017
Processing time: 79 Days and 14.9 Hours
Abstract

Due to the increasing prevalence of clarithromycin resistance, future of management of Helicobacter pylori (H. pylori) infections need to be recognized. To now, clarithromycin was the best effective, well-tolerated and safe antibiotic used in treatment of the bacterium, but, increasing trend of resistance reduced efficacy of recommended regimens. Indeed, gastroenterologists are mostly unable to start appropriate therapy-according to the sensitivity profile-due to the certain difficulties in routine H. pylori culture procedure and being time consuming method. This announcement by World Health Organization (WHO) was an onset to reconsider current challenging dilemma about H. pylori clarithromycin resistant isolates. Therefore, investigating of various factors affecting this nomination by WHO is highly welcomed. In fact, WHO enumerated more than 16 pathogens which seriously threats human life and public health, thus better management or effective guidelines are necessary. Here for the first time, we nominated this phenomenon as ‘‘gastroenterologist’s persistence’’ which should be equally investigated as antibiotic resistance. The ability of gastroenterologists to win the game against H. pylori infections is highly influenced by their collaboration with diagnostic laboratories to apply susceptibility patterns before any prescription. In conclusion, closer collaboration between two important partners (gastroenterologists and microbiologists) in management of H. pylori infection may hopefully trigger an era to remedy current crisis in clarithromycin resistance, a later gastric cancer can be practically preventable.

Keywords: Resistance; Clarithromycin; Helicobacter pylori; World Health Organization

Core tip: Due to the increasing prevalence of clarithromycin resistance, future of management of Helicobacter pylori (H. pylori) infections need to be rewritten. To now, clarithromycin was the best tolerated and safe antibiotic used in treatment of the bacterium, but, increasing trend of resistance reduced efficacy of therapeutic regimens recommended. In this paper, we discussed that why persistence of gastroenterologists is a critical item need to be considered if we really aim to increase efficacy of prescribed antibiotics against H. pylori.