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Objectives: Recent guidelines provide insightful information on the diagnosis and treatment of Helicobacter pylori infection. The knowledge of the latest guidelines for European paediatric gastroenterologists is currently being discussed. This study aimed to evaluate the current knowledge regarding paediatric H. pylori management.

Methods: Members from the National Societies of the European Society of Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) were invited to complete an online questionnaire. Descriptive and statistical analyses were conducted using SPSS®.

Results: A questionnaire was completed by 508 paediatric healthcare professionals from 32 countries (60% were specialists, 82% worked in hospitals and 49% in university hospitals). Of these, 360 (71%) had a background in paediatric gastroenterology. In 30% of cases, the local prevalence of H. pylori was unknown. Primary testing indications included duodenal or gastric erosions (85%), oral iron-refractory anaemia (59%) and a positive family history of gastric cancer (41%), 7.5% complied with the guidelines. Fifty-seven per cent requested invasive diagnostic tests, including culture (66%) and molecular tests (34%). The test-and-treat strategy was considered by 43% of clinicians, and more than half of respondents would include probiotics in eradication. Amoxicillin-based therapies represented 77% of prescriptions, with 54% opting for clarithromycin for empirical treatment. Additionally, the eradication regimens varied significantly across different European regions, with limited/small differences by clinician category.

Conclusions: This study among healthcare professionals revealed that H. pylori infection management does not entirely follow the guidelines regarding indications, testing and treatment regimens. There is a need for education in Europe to increase literacy and clinical updates.