Current practice of gastroenterologist in th etreatment of Helicobacter pylori infection in Italy: data from Italian Registry on H. pylory treatment

Background and aim: Guidelines recommend several antimicrobial regimens for Helicobacter (H.) pylori eradication. Data regarding the type of regimen prescribed in clinical practice in Italy are not yet available. The aim of this study is to assess the practice of gastroenterologists in the treatment of H. pylori infection in Italy. Material and methods: The “Italian Registry on H. pylori treatment” is an online database prospectively registering adult patients prescribed with a treatment for H. pylori infection by gastroenterologists in Italy. Data were collected from 18 centers from June 2017 to October 2018 using the web application REDCap (Research Electronic Data Capture). Results: A total of 1069 patients [679 (63.8%) females, mean age (SD): 54.0 years (15.3)] were assessed. Of these, 1009 patients received one treatment, 58 two treatments and 2 three treatments for H. pylori eradication, with a total of 1131 treatment regimens prescribed. Of the 1131 treatments, 838 were prescribed at first line and 293 after a previous treatment failure. At first-line, the most frequent regimen was sequential therapy (350, 41.8%), followed by the new formulation of bismuth quadruple therapy (Pylera®) (220, 26.3%), clarithromycin-containing triple therapy (219, 26.1%), concomitant (42, 5%) and other therapies (7, 0.8%). Figure 1 shows sequential therapy prescribed at first line by Center. After a previous treatment failure, Pylera® (138, 47.1%) was the most frequent regimen prescribed, followed by levofloxacin-containing triple therapy (84, 28.7%), rifabutin-containing triple therapy (36, 12.3%), sequential therapy (21, 7.2%), concomitant (8, 2.7%) and other therapies (6, 2%). Most regimens, including clarithromicin-containing triple therapy, were prescribed for 10 days (876/1131, 77.5%). Conclusions: Sequential therapy and Pylera® appear to be the most frequently prescribed regimens for H. pylori eradication in Italy. Most regimens, including clarithromycin-containing triple therapy, were prescribed for 10 days.