Therapy and diagnostic tests used for Helicobacter pylori infection in the Scandinavian countries in 1998.
BACKGROUND
We wanted to ascertain how Helicobacter pylori infection is managed in Scandinavia.


METHODS
A one-page questionnaire with seven questions was mailed in April 1998 to 1718 gastroenterologists in Finland, Denmark, Norway, and Sweden (excluding Swedish surgeons).


RESULTS
The questionnaire was returned by 36%. Antimicrobials were used by 99% for peptic ulcer associated with H. pylori, by 67% for mucosa-associated lymphoid tissue lymphoma, by 27% before long-term therapy with a proton-pump inhibitor (PPI), by 16% for non-ulcer dyspepsia, by 11% for reflux disease, and by 11% for other indications. In Finland several conditions other than ulcer were treated more frequently than in the other countries. The commonest primary therapy is PPI triple therapy (94%), followed by bismuth-based (11%), 'other' (2%), and PPI dual therapy (0.2%). Primary bismuth-based therapy was almost completely limited to Norway. The commonest secondary therapy for failures was also PPI triple therapy (71%), followed by bismuth-based (41%), 'other' (10%), and PPI dual therapy (1%). Clarithromycin for primary therapy was used much less frequently in Finland than in the other countries. Follow-up to ascertain whether eradication is successful was done always or often by 90% in Finland, 63% in Norway, 62% in Sweden, and 21% in Denmark and by 61% of the internists and 42% of the surgeons. The commonest method to confirm eradication was gastroscopy (69%), followed by the breath test (52%) and serology (11%).


CONCLUSIONS
In Scandinavia H. pylori associated with peptic ulcer disease is treated with antimicrobials by virtually all gastroenterologists. PPI triple therapy is the commonest regimen for primary and secondary eradication. PPI dual therapy has essentially disappeared. Fifty-four per cent confirm eradication always or often, with gastroscopy being the commonest method.
Olafsson
S
S
Institute of Medicine, Division of Gastroenterology, Haukeland University Hospital, Bergen, Norway.
Berstad
A
A
D000863:Antacids / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001729:Bismuth / Q000627:therapeutic use; D001944:Breath Tests; D004359:Drug Therapy, Combination; D004791:Enzyme Inhibitors / Q000627:therapeutic use; D005767:Gastrointestinal Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D005773:Gastroscopy; D016481:Helicobacter Infections / Q000175:diagnosis* / Q000188:drug therapy*; D016480:Helicobacter pylori; D006801:Humans; D010818:Practice Patterns, Physicians'; D054328:Proton Pump Inhibitors; D012537:Scandinavian and Nordic Countries; D012698:Serologic Tests
D000863:Antacids; D000900:Anti-Bacterial Agents; D004791:Enzyme Inhibitors; D054328:Proton Pump Inhibitors; D001729:Bismuth