Room for Improvement in the Treatment of Helicobacter pylori Infection: Lessons from the European Registry on: H. pylori: Management (Hp-EuReg) : Journal of Clinical Gastroenterology

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Room for Improvement in the Treatment of Helicobacter pylori Infection

Lessons from the European Registry on H. pylori Management (Hp-EuReg)

Nyssen, Olga P. BSc, PhD*; Vaira, Dino MD; Tepes, Bojan MD; Kupcinskas, Limas MD§; Bordin, Dmitry MD; Pérez-Aisa, Ángeles MD; Gasbarrini, Antonio MD#; Castro-Fernández, Manuel MD**; Bujanda, Luis MD††; Garre, Ana MD*; Lucendo, Alfredo MD‡‡; Vologzhanina, Liudmila MD§§; Jurecic, Natasa B. MD∥∥; Rodrigo-Sáez, Luis MD¶¶; Huguet, Jose M. MD##; Voynovan, Irina MD; Perez-Lasala, Jorge MD***; Romero, Pilar Mata MD†††; Vujasinovic, Miroslav MD‡‡‡; Abdulkhakov, Rustam MD§§§; Barrio, Jesús MD∥∥∥; Fernandez-Salazar, Luis MD¶¶¶; Mégraud, Francis MD###; O’Morain, Colm MD****; Gisbert, Javier P. MD, PhD*

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Journal of Clinical Gastroenterology 56(2):p e98-e108, February 2022. | DOI: 10.1097/MCG.0000000000001482



Managing Helicobacter pylori infection requires constant decision making, and each decision is open to possible errors.


The aim was to evaluate common mistakes in the eradication of H. pylori, based on the “European Registry on Helicobacter pylori management”.


European Registry on Helicobacter pylori management is an international multicentre prospective noninterventional registry evaluating the decisions and outcomes of H. pylori management by European gastroenterologists in routine clinical practice.


Countries recruiting more than 1000 patients were included (26,340 patients). The most common mistakes (percentages) were: (1) To use the standard triple therapy where it is ineffective (46%). (2) To prescribe eradication therapy for only 7 to 10 days (69%). (3) To use a low dose of proton pump inhibitors (48%). (4) In patients allergic to penicillin, to prescribe always a triple therapy with clarithromycin and metronidazole (38%). (5) To repeat certain antibiotics after eradication failure (>15%). (6) Failing to consider the importance of compliance with treatment (2%). (7) Not to check the eradication success (6%). Time-trend analyses showed progressive greater compliance with current clinical guidelines.


The management of H. pylori infection by some European gastroenterologists is heterogeneous, frequently suboptimal and discrepant with current recommendations. Clinical practice is constantly adapting to updated recommendations, although this shift is delayed and slow.

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