The ¹³C Urea breath test is the non-invasive test of choice for the diagnosis of Helicobacter pylori (H pylori) infection. Test and treat is now becoming widely recognised as the optimal approach to the management of H pylori infection. The aim of this study was to examine the prescribing of H pylori eradication therapies to patients attending a GP open-access H pylori breath test clinic.

We included 805 patients from the Eastern Health Regional Area who had undergone a hospital based ¹³C-Urea breath test at the H pylori clinic during January 2001-December 2002 for their first assessment. Results of whether the test for H pylori infection was positive or negative were communicated to the referring general practitioners. These patients were linked, using mutual identifiers, to prescribing claims data available through the General Medical Services (GMS) scheme, a means-tested scheme providing free medicines to all these patients. Prescription of any eradication therapy, including adequate triple therapy regimens, any proton pump inhibitor (PPI) or H₂ receptor antagonist (H2 antagonist) and two antibiotics, was examined for up to 3 months from the test date. The average age in the study was 48 years (SD=18), with a higher proportion of women (63%) compared with men. Of the 805 patients in the study 374 (46.5%) were positive for H pylori and 431 (53.5%) were negative.

Therapies prescribed after testing are shown in Table 1. Almost one quarter of those with positive results were prescribed no treatment and only 60.4% were prescribed adequate triple therapy.Table 1:Any anti-H pylori therapies prescribed after H pylori testing.

These results show clear under-prescribing and inappropriate prescribing of H pylori eradication therapy despite positive testing. These findings suggest that prescribers are commonly not acting on the results of H pylori testing.