Therapy and diagnostic tests used for Helicobacter pylori infection in theScandinavian countries in 1998

Background: We wanted to ascertain how Helicobacter pylori infection is man aged in Scandinavia. Methods: A one-page questionnaire with seven questions was mailed in April 1998 to 1718 gastroenterologists in Finland, Denmark, Norway, and Sweden (excluding Swedish surgeons). Results: The questionnaire was returned by 36%. Antimicrobials were used by 99% for peptic ulcer asso ciated with H. pylori, by 67% for mucosa-associated lymphoid tissue lymphom a, by 27% before long-term therapy with a proton-pump inhibitor (PPI), by 1 6% for non-ulcer dyspepsia, by 11% for reflux disease, and by 11% for other indications. In Finland several conditions other than ulcer were treated m ore frequently than in the other countries. The commonest primary therapy i s PPI triple therapy (94%), followed by bismuth-based (11%), 'other' (2%), and PPI dual therapy (0.2%). Primary bismuth-based therapy was almost compl etely limited to Norway. The commonest secondary therapy for failures was a lso PPI triple therapy (71%), followed by bismuth-based (41%), 'other' (10% ), and PPI dual therapy (1%). Clarithromycin for primary therapy was used m uch less frequently in Finland than in the other countries. Follow-up to as certain whether eradication is successful was done always or often by 90% i n Finland, 63% in Norway, 62% in Sweden, and 21% in Denmark and by 61% of t he internists and 42% of the surgeons. The commonest method to confirm erad ication was gastroscopy (69%), followed by the breath test (52%) and serolo gy (11%). Conclusions: In Scandinavia H. pylori associated with peptic ulce r disease is treated with antimicrobials by virtually all gastroenterologis ts. PPI triple therapy is the commonest re,regimen for primary and secondar y eradication. PPI dual therapy has essentially disappeared. Fifty-four per cent confirm eradication always or often, with gastroscopy being the commo nest method.