Review for 10.1186/s12876-020-01549-9 (2020)

Reviewer’s report
Title: 
Assessment of a novel method to detect clarithromycin-resistant
Helicobacter pylori using a stool antigen test reagent
Version: 
1 
Date: 
18 Aug 2020
Reviewer's report:
An interesting study that deserves to be published, however, the English needs to
be improved to make it more understandable. 
1. 
What age were the students 
2. 
In the first study patients were tested for the presence of H pylori by a urine
test and if positive had the stool antigen test , from these results it appears the
stool antigen test should replace the urine test 
3. 
The HP resistance rates were high and current recommendations would
suggest to abandon Clarithromycin if the resistance rates are greater than 20% 
4. 
The treatment with 20mgs Vonoprazan and 750mgs Amoxicillin and 200mgs
Clarithromycin twice a day was almost equally effective in Clarithromcyin
sensitive and resistant strains, this would suggest that future treatment should be
with dual therapy 
5. 
In those students who failed eradication therapy was second line treatment
given to them and if so what treatment and was this successful 
6. 
The second study on adults consisted of 23 patients, it took a long time to
recruit these patients was there any reason for this delay 
7. Is there any explanation for the high resistant rates in the students are they
were unlikely to be exposed to antibiotics 
8. 
I accept there was good correlation between culture and the novel stool
antigen test for resistance which makes the study very interesting 
9. 
On page 13, line 4 spreads in Japan does not make sense 
10 
On page 13, line 6, tolerance does this mean sensitivity 
11. Table 3 is cumbersome and could be explained in text 
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Is the study design appropriate to answer the research question (including the use
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