[How do primary care physicians manage their patients with Helicobacter pylori infection? Results of a survey and their implementation into the German S2k guideline 2016].

Background The German S3 guideline "H. pylori and gastroduodenal ulcer disease" clearly recommends how to diagnose H. pylori infection. It also states when and how eradication therapy should be done. However, there are only few data available on the management of these patients in daily routine. With this survey, we wanted to gather information on how primary care physicians are involved in the management of H. pylori infection and how they follow the guideline recommendations. From this, consequences for the update of the new S2k guideline 2016 and their communication should be derived. Methods A questionnaire with 16 items was sent to all registered primary care physicians in the district of Unterfranken, Germany. Of the 607 questionnaires sent out, 188 (31 %) were returned. Results A test for H. pylori was induced in 76 % of cases with a history of ulcers, 66 % of dyspepsia, 55 % of a family history of gastric cancer, 54 % of unspecific abdominal discomfort, and 9 % and 6 % before initiating NSAID or ASS medication, respectively. Eighty-six percent of the physicians referred their patients to a gastroenterologist for further diagnostics, 45,8 % initiated eradication therapy by themselves, and 75 % and 25 % favored the French and Italian protocol, respectively. The majority did not consider a possible primary resistance to clarithromycine. Twenty-six percent did not regularly control the success of first-line eradication therapy. In case of control, the time intervals after end of eradication treatment are nearly always considered. Second-line therapy is initiated in 99 %, and its success is checked in 87 %. Conclusion Management of patients with H. pylori infection does not always follow the recommendations of current guidelines. The reasons for that were addressed in the formulation of the updated S2k guideline and will be communicated.