{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T11:43:35Z","timestamp":1792496615971,"version":"4.5.0"},"reference-count":30,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"vor","delay-in-days":31,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100014013","name":"UK Research and Innovation","doi-asserted-by":"publisher","award":["10058099"],"award-info":[{"award-number":["10058099"]}],"id":[{"id":"10.13039\/100014013","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100019486","name":"Biocodex Microbiota Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100019486","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Helicobacter"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      <jats:styled-content style=\"fixed-case\">\n                        <jats:italic>Helicobacter pylori<\/jats:italic>\n                      <\/jats:styled-content>\n                      is a common infection primarily managed in primary care. Assessing real\u2010world practices and guideline adherence is crucial for treatment optimisation. The study aims to assess current\n                      <jats:styled-content style=\"fixed-case\">\n                        <jats:italic>H. pylori<\/jats:italic>\n                      <\/jats:styled-content>\n                      management strategies using data from BIFAP, a Spanish primary care database.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>\n                      Cohort study including patients aged \u2265\u200918 with recorded\n                      <jats:styled-content style=\"fixed-case\">\n                        <jats:italic>H. pylori<\/jats:italic>\n                      <\/jats:styled-content>\n                      infection (2003\u20132023) and corresponding treatment prescriptions. Infection cases were identified using ICD\u20109\/10 and SNOMED\u2010CT codes. Treatment patterns were based on Spanish and European guidelines. First\u2010line treatment prescriptions were compared between primary (BIFAP) and specialized (European Registry, Hp\u2010EuReg) care.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 211,972\n                      <jats:italic>\n                        <jats:styled-content style=\"fixed-case\">H. pylori<\/jats:styled-content>\n                        \u2010\n                      <\/jats:italic>\n                      infected subjects were identified. Over the study period (20\u2009years), the predominant first\u2010line treatments were: bismuth quadruple therapy including a proton\u2010pump inhibitor (PPI) plus a single capsule containing bismuth\u2010tetracycline\u2010metronidazole (36%); PPI\u2009+\u2009clarithromycin\u2010amoxicillin (30%); and PPI\u2009+\u2009clarithromycin\u2010amoxicillin\u2010metronidazole (26%). Single\u2010capsule bismuth quadruple therapy was the most common in patients aged 18\u201364 and those with obesity, chronic kidney disease, or smokers, while PPI\u2009+\u2009clarithromycin\u2010amoxicillin was more common in those aged \u2265\u200965 or with peptic ulcers. Since 2013, PPI\u2009+\u2009clarithromycin\u2010amoxicillin use by general practitioners and gastroenterologists decreased, though it remained above 10% in primary care at study end. PPI\u2009+\u2009clarithromycin\u2010amoxicillin\u2010metronidazole increased since 2015, with higher use in specialized care (40%) vs. primary care (30%). In 2023, single\u2010capsule bismuth quadruple therapy was the most prescribed regimen in both settings, accounting for ~60% of prescriptions.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Primary care\n                      <jats:styled-content style=\"fixed-case\">\n                        <jats:italic>H. pylori<\/jats:italic>\n                      <\/jats:styled-content>\n                      treatments are varied, with single\u2010capsule bismuth quadruple therapy most prescribed. Guidelines are followed, but adoption is slower in primary than in specialized care.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hel.70122","type":"journal-article","created":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T04:16:35Z","timestamp":1775103395000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["<scp>\n                      <i>Helicobacter pylori<\/i>\n                    <\/scp>\n                    Eradication Primary Care First\u2010Line Prescriptions: Data From 200,000 Patients in a Real\u2010World Cohort"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9477-7977","authenticated-orcid":false,"given":"Encarnaci\u00f3n","family":"Fern\u00e1ndez\u2010Ant\u00f3n","sequence":"first","affiliation":[{"name":"Department of Biomedical Sciences (Pharmacology), School of Medicine and Health Sciences University of Alcal\u00e1 (IRYCIS)  Alcal\u00e1 de Henares Spain"},{"name":"Te\u00f3filo Hernando Foundation  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4920-9310","authenticated-orcid":false,"given":"Olga P.","family":"Nyssen","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Hospital Universitario de La Princesa, Instituto de Investigaci\u00f3n Sanitaria Princesa (IIS\u2010Princesa), Universidad Aut\u00f3noma de Madrid (UAM), and Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Hep\u00e1ticas y Digestivas (CIBERehd)  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriela","family":"Alonso\u2010Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences (Pharmacology), School of Medicine and Health Sciences University of Alcal\u00e1 (IRYCIS)  Alcal\u00e1 de Henares Spain"},{"name":"Te\u00f3filo Hernando Foundation  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-8597-2206","authenticated-orcid":false,"given":"Pablo","family":"Parra","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Hospital Universitario de La Princesa, Instituto de Investigaci\u00f3n Sanitaria Princesa (IIS\u2010Princesa), Universidad Aut\u00f3noma de Madrid (UAM), and Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Hep\u00e1ticas y Digestivas (CIBERehd)  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel","family":"Gil","sequence":"additional","affiliation":[{"name":"BIFAP Unit, Division of Pharmacoepidemiology and Pharmacovigilance, Spanish Medicines Agency Hospital Universitario de La Princesa, Instituto de Investigaci\u00f3n Sanitaria Princesa (IIS\u2010Princesa) Universidad Aut\u00f3noma de Madrid (UAM), and Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Hep\u00e1ticas y Digestivas (CIBERehd)  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2090-3445","authenticated-orcid":false,"given":"Javier P.","family":"Gisbert","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Hospital Universitario de La Princesa, Instituto de Investigaci\u00f3n Sanitaria Princesa (IIS\u2010Princesa), Universidad Aut\u00f3noma de Madrid (UAM), and Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Hep\u00e1ticas y Digestivas (CIBERehd)  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco J.","family":"de Abajo","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences (Pharmacology), School of Medicine and Health Sciences University of Alcal\u00e1 (IRYCIS)  Alcal\u00e1 de Henares Spain"},{"name":"Clinical Pharmacology Unit, University Hospital Pr\u00edncipe de Asturias  Alcal\u00e1 de Henares 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