Helicobacter pylori Eradication Primary Care First-Line Prescriptions: Data From 200,000 Patients in a Real-World...

Area of Science:

• Infectious Diseases
• Gastroenterology
• Primary Care Medicine

Background:

• Helicobacter pylori infection is prevalent and managed mainly in primary care settings.
• Optimizing treatment requires understanding real-world practices and guideline adherence.
• This study analyzes H. pylori management in Spanish primary care using BIFAP database data.

Purpose of the Study:

• To assess current H. pylori management strategies in primary care.
• To evaluate adherence to treatment guidelines in real-world settings.
• To compare treatment patterns between primary and specialized care.

Main Methods:

• A cohort study analyzed 211,972 patients with H. pylori infection (2003-2023).
• Infection was identified using ICD-9/10 and SNOMED-CT codes.
• Treatment prescriptions were compared against Spanish and European guidelines, contrasting primary (BIFAP) and specialized (Hp-EuReg) care.

Main Results:

• Bismuth quadruple therapy (PPI + single capsule bismuth-tetracycline-metronidazole) was the most frequent first-line treatment (36%).
• Other common regimens included PPI + clarithromycin-amoxicillin (30%) and PPI + clarithromycin-amoxicillin-metronidazole (26%).
• While guideline adherence is evident, adoption of newer regimens like single-capsule bismuth quadruple therapy is slower in primary care than in specialized settings.

Conclusions:

• H. pylori treatment in primary care is diverse, with single-capsule bismuth quadruple therapy being the most prescribed.
• Guideline adherence is present but shows a slower adoption rate in primary care compared to specialized care.
• Real-world data highlights evolving treatment landscapes and areas for improved guideline implementation.