Discrepancies between primary physician practice and treatment guidelines for Helicobacter pylori infection in Korea

To evaluate the attitude of primary care physicians in the diagnosis and treatment of Helicobacter pylori (H. pylori) infection.

Primary care physicians in the Seoul metropolitan area answered self-administered questionnaire from January to March 2003.

One hundred and eight doctors responded to the questionnaire. The most frequent reasons for testing H. pylori infection were gastric and duodenal ulcers (93.5% and 88.9%, respectively). For patients with H. pylori positive dyspepsia, 28.7% of doctors always tried to eradicate the worm and 34.4% treated selectively. A large proportion (28.7%) of primary care physicians treated H. pylori on a patient's request basis. Only 9.3% of primary care physicians always conducted follow-up testing after treating H. pylori infection. When H. pylori was not cleared by the first treatment, 40.7% of doctors reused the same regimen, 16.7% changed to another triple regimen and 25% to a quadruple regimen.

It has been well documented that the issuance of guidelines alone has little impact on practice. Communication between primary care physicians and gastroenterologists in the form of continuous medical education is required.