{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T17:09:35Z","timestamp":1777655375784,"version":"3.51.4"},"reference-count":42,"publisher":"BMJ","issue":"1","funder":[{"name":"European Helicobacter and Microbiota Study Group"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Gut"],"accepted":{"date-parts":[[2020,6,26]]},"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>The best approach for<jats:italic>Helicobacter pylori<\/jats:italic>management remains unclear. An audit process is essential to ensure clinical practice is aligned with best standards of care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>International multicentre prospective non-interventional registry starting in 2013 aimed to evaluate the decisions and outcomes in<jats:italic>H. pylori<\/jats:italic>management by European gastroenterologists. Patients were registered in an e-CRF by AEG-REDCap. Variables included demographics, previous eradication attempts, prescribed treatment, adverse events and outcomes. Data monitoring was performed to ensure data quality. Time-trend and geographical analyses were performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>30 394 patients from 27 European countries were evaluated and 21 533 (78%) first-line empirical<jats:italic>H. pylori<\/jats:italic>treatments were included for analysis. Pretreatment resistance rates were 23% to clarithromycin, 32% to metronidazole and 13% to both. Triple therapy with amoxicillin and clarithromycin was most commonly prescribed (39%), achieving 81.5% modified intention-to-treat eradication rate. Over 90% eradication was obtained only with 10-day bismuth quadruple or 14-day concomitant treatments. Longer treatment duration, higher acid inhibition and compliance were associated with higher eradication rates. Time-trend analysis showed a region-dependent shift in prescriptions including abandoning triple therapies, using higher acid-inhibition and longer treatments, which was associated with an overall effectiveness increase (84%\u201390%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Management of<jats:italic>H. pylori<\/jats:italic>infection by European gastroenterologists is heterogeneous, suboptimal and discrepant with current recommendations. Only quadruple therapies lasting at least 10 days are able to achieve over 90% eradication rates. European recommendations are being slowly and heterogeneously incorporated into routine clinical practice, which was associated with a corresponding increase in effectiveness.<\/jats:p><\/jats:sec>","DOI":"10.1136\/gutjnl-2020-321372","type":"journal-article","created":{"date-parts":[[2020,9,21]],"date-time":"2020-09-21T21:21:15Z","timestamp":1600723275000},"page":"40-54","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":227,"title":["European Registry on<i>Helicobacter pylori<\/i>management (Hp-EuReg): patterns and trends in first-line empirical eradication prescription and outcomes of 5 years and 21\u2009533 patients"],"prefix":"10.1136","volume":"70","author":[{"given":"Olga 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