title: A national survey of primary care physicians' perceptions and practices related to Helicobacter pylori infection.
abstract: OBJECTIVE
  Our aim was to assess current perceptions and practices of primary care physicians in the United States concerning Helicobacter pylori infection.
  
  
  METHODS
  We mailed a structured questionnaire to approximately 2500 primary care physicians 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
  We received 424 responses from 2349 questionnaires (18%). Only 3% each had used either the C- or C-urea breath test; 5% had used the stool antigen test; 92% and 91% recommended testing-and 90% and 82% treatment-for H. pylori in patients with active duodenal and gastric ulcer, respectively. However, only 64% would test for and only 59% would treat H. pylori infection in a patient with past history of duodenal ulcer. Almost half would test patients with gastroesophageal reflux disease being started or maintained on a proton pump inhibitor. The most frequent treatment regimens used were combinations of a proton pump inhibitor, clarithromycin, and either amoxicillin or metronidazole. Most respondents had inaccurate information on antibiotic resistance rates for H. pylori. In the absence of symptoms, 26% would personally undergo testing for H. pylori; 30% would be treated if infected.
  
  
  CONCLUSIONS
  Primary care physicians usually test for and treat H. pylori infection in patients with active ulcer, but fail to do so in patients with a prior history of ulcer. Some test for H. pylori in gastroesophageal reflux disease patients. Most use efficacious treatment regimens, but have inaccurate information on resistance rates.
authors.affiliation: Department of Internal Medicine, Mayo Clinic, Arizona, Scottsdale AZ, USA. sharma.virender@mayo.edu
authors.forename: Virender K
authors.initials: VK
authors.lastname: Sharma
authors.forename: Colin W
authors.initials: CW
authors.lastname: Howden
mesh_terms: D000658:Amoxicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D017291:Clarithromycin / Q000627:therapeutic use; D024881:Drug Resistance, Bacterial; D004359:Drug Therapy, Combination; D016481:Helicobacter Infections / Q000188:drug therapy*; D006801:Humans; D008795:Metronidazole / Q000627:therapeutic use; D010821:Physicians, Family / Q000145:classification; D011897:Random Allocation; D011795:Surveys and Questionnaires; D014481:United States
chemical_list: D000900:Anti-Bacterial Agents; D008795:Metronidazole; D000658:Amoxicillin; D017291:Clarithromycin