Letters To The Editor
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Oct 7, 2017; 23(37): 6920-6922
Published online Oct 7, 2017. doi: 10.3748/wjg.v23.i37.6920
Resistance of Helicobacter pylori to furazolidone and levofloxacin: A viewpoint
Mohammad Zamani, Arash Rahbar, Javad Shokri-Shirvani
Mohammad Zamani, Arash Rahbar, Student Research Committee, Babol University of Medical Sciences, Babol 47176-47745, Iran
Mohammad Zamani, Cancer Research Center, Health Research Institute, Babol University of Medical Sciences, Babol 47176-47745, Iran
Javad Shokri-Shirvani, Department of Internal Medicine, Babol University of Medical Sciences, Babol 47176-47745, Iran
Author contributions: Zamani M and Shokri-Shirvani J contributed in study design; Zamani M and Rahbar A drafted the manuscript; Shokri-Shirvani J revised the manuscript for important intellectual content; All authors have read the manuscript and approved its final version.
Conflict-of-interest statement: The authors declared no conflict of interest.
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: Javad Shokri-Shirvani, MD, Department of Internal Medicine, Babol University of Medical Sciences, Ganjafrooz Street, Babol 47176-47745, Mazandaran, Iran. j.shokri@mubabol.ac.ir
Telephone: +98-11-32199592 Fax: +98-11-32190971
Received: June 29, 2017
Peer-review started: June 30, 2017
First decision: July 13, 2017
Revised: July 30, 2017
Accepted: August 15, 2017
Article in press: August 15, 2017
Published online: October 7, 2017
Abstract

In their review, Arslan et al[1] did not describe the status of Helicobacter pylori (H. pylori) treatment with furazolidone and the resistance to this antibiotic. We have presented different surveys showing the resistance of H. pylori to furazolidone from Asia and South America. The resistance rates varied but were mostly low (< 5%). There are not enough data on its efficacy and resistance in the United States and Europe. H. pylori mutations occurring in the oorD gene, including A041G, A122G, C349A(G), A78G, A112G, A335G, C156T and C165T, and in the porD gene, including G353A, A356G, C357T, C347T, C347G and C346A, have been indicated to be possibly related to the observed resistance. Additionally, to complete Arslan et al’s statement regarding levofloxacin resistance, it should be noted that compound mutations of N87A, A88N and V65I at codon Asn-87 were recently observed in the gyrA gene for the first time. However, the results on these topics are not sufficient, and more worldwide studies are suggested.

Keywords: Susceptibility, Furazolidone, Helicobacter pylori, Resistance, Levofloxacin, Treatment

Core tip: We have presented different surveys showing the resistance of Helicobacter pylori (H. pylori) to furazolidone from Asia and South America. The resistance rates varied but were mostly low (< 5%). H. pylori mutations occurring in the oorD gene, including A041G, A122G, C349A(G), A78G, A112G, A335G, C156T and C165T, and in the porD gene, including G353A, A356G, C357T, C347T, C347G and C346A, have been indicated to be possibly related to the observed resistance. Regarding levofloxacin resistance, compound mutations of N87A, A88N and V65I at codon Asn-87 were recently observed in the gyrA gene for the first time.