|LETTER TO THE EDITOR
|Year : 2016 | Volume
| Issue : 3 | Page : 154-155
Call for global vaccine instead of Helicobacter pylori blind antibiotic therapy
Amin Talebi Bezmin Abadi
Department of Bacteriology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
|Date of Web Publication||23-Aug-2016|
Amin Talebi Bezmin Abadi
Department of Bacteriology, Faculty of Medical Sciences, Tarbiat Modares University, P. O. Box: 14115-111, Tehran
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Abadi AT. Call for global vaccine instead of Helicobacter pylori blind antibiotic therapy. Ann Afr Med 2016;15:154-5
We read the great paper by Abdollahi et al. entitled "Is Helicobacter pylori infection a risk factor for idiopathic thrombocytopenic purpura (ITP) in children?" In the recent issue of Annals of African Medicine.  Regarding this article, some critical points are worth considering which are listed in below. ITP is an autoimmune disease identified by increased platelet destruction caused by antiplatelet autoantibodies. H. pylori successfully colonizes the human gastric epithelium of more than 50% world population. ,, There is a long list of extradigestive diseases that suspected to be linked with H. pylori colonization in the human stomach. 
Broadly defined, H. pylori is a smart human pathogen that it can easily subvert immune response to establish lifelong infection. Since such a large number of infected individuals, global eradication of this bacterium is not practically possible. Moreover, prescribing inefficient antibiotics can result in increasing rate of antibiotic resistance. Finally, it is clear that H. pylori clearance and reduced chance of associated diseases call for a prophylactic vaccine which is preventive, safe, and cheap.
- In this paper, authors suggested that urea breath test (UBT) is recommended for testing the infection. UBT administration in adults seems likely possible, but due to the ethical issue and other difficulty in children, it seems that another interventions are needed. Consequently, current recommendation cannot be practically suitable for ITP children patients
- Supposing, eradication of H. pylori is accepted as a new strategy for ITP patients; now, the challenging question would be the "is this bacterial elimination actually cost-effective?" So far, it has been asserted that screening and treatment for H. pylori is cost-effective only in peptic ulcer and gastric cancer patients. In addition, because of lacking data on local prevalence of this bacterium, this totally eradication may be not feasible
- Notably, in the current study by Abdollahi et al., small numbers of children were selected, as generally accepted, investigations with larger numbers of participants will be necessary to fix such direct conclusion.  It is now firmly established that in clinical trials concerning H. pylori and any kind of extradigestive disorders, we need to have adequate sample size.
The contents of this review article are the sole responsibility of the author and necessarily represent personal perspective.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Abdollahi A, Shoar S, Ghasemi S, Zohreh OY. Is Helicobacter pylori
infection a risk factor for idiopathic thrombocytopenic purpura in children? Ann Afr Med 2015;14:177-81.
Abadi AT, Taghvaei T, Mobarez AM, Carpenter BM, Merrell DS. Frequency of antibiotic resistance in Helicobacter pylori
strains isolated from the northern population of Iran. J Microbiol 2011;49:987-93.
Talebi Bezmin Abadi A. Therapy of Helicobacter pylori
: Present medley and future prospective. Biomed Res Int 2014;2014:124607.
Talebi Bezmin Abadi A, Ghasemzadeh A, Taghvaei T, Mobarez AM. Primary resistance of Helicobacter pylori
to levofloxacin and moxifloxacine in Iran. Intern Emerg Med 2012;7:447-52.
Malfertheiner P, Megraud F, O'Morain CA, Atherton J, Axon AT, Bazzoli F, et al.
Management of Helicobacter pylori
infection - The Maastricht IV/Florence Consensus Report. Gut 2012;61:646-64.