RESUMO
Today, antibiotic resistance of Helicobacter pylori (HP) is a worldwide problem. The 'test and treat' strategy is the recommended approach in family medicine, as family medicine doctors make decisions on treating gastrointestinal conditions without endoscopic findings or HP testing. In treatment strategy, family medicine doctor has to answer several questions: whether the patient has HP infection, is it necessary to evaluate HP infection, which diagnostic test to use in evaluation of HP infection, should he proscribe antibiotic, and which antibiotic to prescribe. In this article, we present three common clinical cases to determine which approach to use in daily practice: dyspepsia, gastroesophageal reflux disease (GERD), and extragastric diseases associated with HP infection. Serology test, stool antigen test and urea breath test are described. It is required from family medicine doctors not only to rationalize antibiotic prescription but also to eradicate HP infection at the same time. We need to have in mind that disease is a result of the host-agent (bacterium) interaction that varies in time and possible damage/impairment from the disease.