Management of Helicobacter pylori Infection in Spain Beyond the Data Collected in the European Registry on H. pylori Management (Hp-EuReg): Results of a Nationwide Survey.

[BACKGROUND] The management of Helicobacter pylori (H. pylori) infection encompasses different diagnostic and therapeutic procedures.

[MATERIALS AND METHODS] A survey was developed to investigate further factors of the clinical practice concerning the management of H. pylori infection that are currently not collected within the European Registry on H. pylori Management (Hp-EuReg). The survey was distributed among Spanish Hp-EuReg investigators, members of the Spanish Gastroenterology Association, and through social media.

[RESULTS] Overall, 128 investigators from all Spanish regions participated (79% from centers enrolling patients in the Hp-EuReg). Most participants (66%) reported having at least five diagnostic methods available. Culture was usually performed following the second-line failure (64%). Contrary to the recommendations, 17% of physicians did not investigate H. pylori infection in patients admitted for peptic ulcer bleeding, and 35% did not treat the infection right away. Furthermore, most investigators (95%) did not test for the infection in cohabitants, and 32% in gastric cancer relatives. The test-and-treat strategy was used in 84% of patients under 55 years without alarm symptoms, and in 15% of patients over 55 years. The majority (74%) did not confirm the penicillin allergy, only 26% were aware of the local clarithromycin resistance rate, and 37% periodically evaluated the efficacy of eradication treatments. Finally, most Spanish investigators (83%) followed the V Spanish Consensus, while up to 35% followed the Maastricht VI recommendation guidelines.

[CONCLUSIONS] The management of H. pylori infection in Spain is suboptimal, even among Hp-EuReg investigators. We must optimize H. pylori management by implementing educational measures adapted to each setting.

[TRIAL REGISTRATION] ClinicalTrials.gov: NCT02328131.