Olga P Nyssen1, Dino Vaira2, Bojan Tepes3, Limas Kupcinskas4, Dmitry Bordin5, Ángeles Pérez-Aisa6, Antonio Gasbarrini7, Manuel Castro-Fernández8, Luis Bujanda9, Ana Garre1, Alfredo Lucendo10, Liudmila Vologzhanina11, Natasa B Jurecic12, Luis Rodrigo-Sáez13, Jose M Huguet14, Irina Voynovan5, Jorge Perez-Lasala15, Pilar Mata Romero16, Miroslav Vujasinovic17, Rustam Abdulkhakov18, Jesús Barrio19, Luis Fernandez-Salazar20, Francis Mégraud21, Colm O'Morain22, Javier P Gisbert1. 1. Gastroenterology Unit, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Universidad Autónoma de Madrid, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd). 2. Department of Surgical and Clinical Sciences, University of Bologna, Bologna. 3. Gastroenterology Unit, AM DC Rogaska, Rogaska Slatina. 4. Department of Gastroenterology, Lithuanian University of Health Sciences, Kaunas, Lithuania. 5. Department of Pancreatobiliary and Upper GI Diseases, Moscow Clinical Scientific Center, and A.I. Yevdokimov Moscow State University of Medicine and Dentistry, Moscow. 6. Digestive Unit, Agencia Sanitaria Costa del Sol, Marbella, Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Málaga. 7. Gastronterology Area, Fondazione Policlinico Universitario A. Gemelli, Rome, Italy. 8. Digestive Unit, Hospital de Valme, Sevilla. 9. Department of Gastroenterology, Hospital Donostia/Instituto Biodonostia. Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd). Universidad del País Vasco (UPV/EHU), Donostia. 10. Hospital de Tomelloso, Ciudad Real, Tomelloso. 11. Gastrocentre Perm, Perm. 12. DC Bled. 13. Gastroenterology Unit, Hospital Universitario Central de Asturias, Oviedo. 14. Hospital General Universitario de Valencia, Valencia. 15. Digestive Service, HM Sanchinarro, Madrid. 16. Hospital San Pedro de Alcántara, Cáceres. 17. Slovenj Gradec General Hospital, Slovenj Gradec, Slovenia. 18. Kazan State Medical University, Kazan, Russia. 19. Hospital Río Hortega. 20. Hospital Clínico Universitario, Valladolid, Spain. 21. Laboratoire de Bactériologie, Hôpital Pellegrin, Bordeaux Cedex, France. 22. Trinity College Dublin, Faculty of Health Sciences, Trinity College Dublin, Dublin/IE, Faculty of Health Sciences, Dublin, Ireland.
Abstract
BACKGROUND: Managing Helicobacter pylori infection requires constant decision making, and each decision is open to possible errors. AIM: The aim was to evaluate common mistakes in the eradication of H. pylori, based on the "European Registry on Helicobacter pylori management". METHODS: European Registry on Helicobacter pylori management is an international multicentre prospective noninterventional registry evaluating the decisions and outcomes of H. pylori management by European gastroenterologists in routine clinical practice. RESULTS: Countries recruiting more than 1000 patients were included (26,340 patients). The most common mistakes (percentages) were: (1) To use the standard triple therapy where it is ineffective (46%). (2) To prescribe eradication therapy for only 7 to 10 days (69%). (3) To use a low dose of proton pump inhibitors (48%). (4) In patients allergic to penicillin, to prescribe always a triple therapy with clarithromycin and metronidazole (38%). (5) To repeat certain antibiotics after eradication failure (>15%). (6) Failing to consider the importance of compliance with treatment (2%). (7) Not to check the eradication success (6%). Time-trend analyses showed progressive greater compliance with current clinical guidelines. CONCLUSION: The management of H. pylori infection by some European gastroenterologists is heterogeneous, frequently suboptimal and discrepant with current recommendations. Clinical practice is constantly adapting to updated recommendations, although this shift is delayed and slow.
BACKGROUND: Managing Helicobacter pylori infection requires constant decision making, and each decision is open to possible errors. AIM: The aim was to evaluate common mistakes in the eradication of H. pylori, based on the "European Registry on Helicobacter pylori management". METHODS: European Registry on Helicobacter pylori management is an international multicentre prospective noninterventional registry evaluating the decisions and outcomes of H. pylori management by European gastroenterologists in routine clinical practice. RESULTS: Countries recruiting more than 1000 patients were included (26,340 patients). The most common mistakes (percentages) were: (1) To use the standard triple therapy where it is ineffective (46%). (2) To prescribe eradication therapy for only 7 to 10 days (69%). (3) To use a low dose of proton pump inhibitors (48%). (4) In patients allergic to penicillin, to prescribe always a triple therapy with clarithromycin and metronidazole (38%). (5) To repeat certain antibiotics after eradication failure (>15%). (6) Failing to consider the importance of compliance with treatment (2%). (7) Not to check the eradication success (6%). Time-trend analyses showed progressive greater compliance with current clinical guidelines. CONCLUSION: The management of H. pylori infection by some European gastroenterologists is heterogeneous, frequently suboptimal and discrepant with current recommendations. Clinical practice is constantly adapting to updated recommendations, although this shift is delayed and slow.