A survey of gastroenterologists' perceptions and practices related to Helicobacter pylori infection.
OBJECTIVE
The aim of this study was to assess the current practice of gastroenterologists in the United States concerning Helicobacter pylori (H. pylori) infection.


METHODS
We mailed a structured questionnaire to 1000 gastroenterologists chosen at random from a national database. We asked about personal and practice demographics and practices relating to testing for, and treating, H. pylori infection.


RESULTS
A total of 922 questionnaires were delivered, from which we received 286 responses (31%). Respondents used many different tests for H. pylori infection, but only 10% each had used either the 13C- or 14C-urea breath test. Testing for H. pylori infection was usually for appropriate reasons, although 21% indicated that they might not treat a patient with a positive test result. Different multiple treatment regimens were used; the most frequent were combinations of a proton pump inhibitor, clarithromycin, and either amoxicillin or metronidazole. Estimates of the prevalence of antibiotic resistance were highly variable and often inaccurate. Most respondents would not check asymptomatic individuals for the infection; however, in the absence of symptoms, 38% would personally undergo testing and treatment if positive.


CONCLUSIONS
Gastroenterologists usually test for H. pylori infection in appropriate conditions, but may not always treat the infection based on a positive test result. Most use efficacious regimens to treat the infection although many have inaccurate information on resistance rates, which may adversely influence prescribing. Many would have testing and, if positive, treatment in the absence of symptoms or a specific diagnosis, but do not recommend this for their patients.
Sharma
V K
VK
Department of Internal Medicine, University of South Carolina School of Medicine, Columbia, USA.
Vasudeva
R
R
Howden
C W
CW
D000658:Amoxicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001291:Attitude of Health Personnel; D001944:Breath Tests; D002247:Carbon Isotopes; D002250:Carbon Radioisotopes; D017291:Clarithromycin / Q000627:therapeutic use; D004352:Drug Resistance, Microbial; D004791:Enzyme Inhibitors / Q000627:therapeutic use; D005762:Gastroenterology; D016481:Helicobacter Infections / Q000175:diagnosis* / Q000188:drug therapy; D016480:Helicobacter pylori; D006801:Humans; D008795:Metronidazole / Q000627:therapeutic use; D010406:Penicillins / Q000627:therapeutic use; D010818:Practice Patterns, Physicians'; D054328:Proton Pump Inhibitors; D019275:Radiopharmaceuticals; D011795:Surveys and Questionnaires; D014508:Urea / Q000032:analysis
D000900:Anti-Bacterial Agents; D002247:Carbon Isotopes; D002250:Carbon Radioisotopes; D004791:Enzyme Inhibitors; D010406:Penicillins; D054328:Proton Pump Inhibitors; D019275:Radiopharmaceuticals; D008795:Metronidazole; D000658:Amoxicillin; D014508:Urea; D017291:Clarithromycin