Levofloxacin in first-line eradication regimens for Helicobacter pylori : better test antibiotic susceptibility before treating

We sincerely congratulate Romano et al 1 for their recent manuscript in Gut showing that levofloxacin-containing sequential therapy can overcome suboptimal cure rates of clarithromycin-containing sequential therapy (≤80% in the intention-to-treat analysis), in a setting with a high clarithromycin resistance rate (20%) but a low levofloxacin resistance rate (3%). Interestingly, we failed to replicate their results in a prior trial with quite a similar design, …