Confusion exists among physicians about the management of Helicobacter pylori infection.
In this study, an international team of researchers surveyed primary care physicians' (PCP) knowledge and management of H. pylori-related diseases.
The team randomly selected 470 PCPs from 29 countries to be surveyed.
The researchers determined that the pathological role of H. pylori was of less concern in South Africa than the rest of the world (63% compared to 93%).
They found that the causal relationship between H. pylori, and gastric and duodenal ulcers, and gastric cancer was accepted by 81%, 85%, and 61% of respondents, respectively.
|63% of respondents considered H. pylori relevant to dyspepsia management.|
|Journal of Gastroenterology and Hepatology|
Overall, endoscopy was used by 62% of respondents to diagnose the infection.
The team found that histology was used by 61% of European participants for diagnosis. This compared to 3% in North America and 0% in South Africa.
The team also found that proton-pump inhibitor (PPI)-based triple therapies were prescribed by 89% of respondents. However, physicians in Oceania (35%) and South Africa (45%) were less concerned about bacterial resistance than respondents elsewhere.
They determined that 63% of respondents considered H. pylori relevant to dyspepsia management. Overall, 66% treated new dyspepsia empirically, compared to 18% who chose endoscopic diagnosis, and 13% who used a H. pylori test and treat strategy.
In the case of persistent or recurrent infection, the team found that 56% of South African physicians treated with another regimen, compared to 33% of PCP from elsewhere.
The researchers found that 91% of European participants agreed that current information on H. pylori management is helpful. Furthermore, 68% of PCP from other regions considered the information to be adequate.
Dr Jiaqing Huang's team concluded, "Current guidelines on the management of H. pylori infection have been useful for PCP worldwide".
"Contrasting answers to some questions may reflect differences in health care systems, epidemiology and approaches to the management of H. pylori infection between countries".