Knowledge, attitudes, and practices regarding Helicobacter pylori resistance among physicians: a multicenter cross-sectional study in Shanxi, China

This study aimed to explore physicians’ knowledge, attitudes, and practices (KAP) regarding Helicobacter pylori ( H. pylori ) resistance to treatment in Shanxi Province, Central China. A multicenter, cross-sectional study was conducted from August to October 2024, enrolling physicians involved in the management of gastrointestinal disorders. A structured questionnaire was developed to collect demographic data and evaluate KAP scores. Structural equation modeling (SEM) was employed to examine the relationships among KAP dimensions. A total of 518 questionnaires were analyzed, with 70.3% of participants being female. The mean knowledge, attitude, and practice scores were 37.67 ± 7.57 (range: 10–50), 28.78 ± 3.41 (range: 7–35), and 27.98 ± 4.26 (range: 7–35), respectively. Knowledge scores (OR = 1.081, 95%CI: 1.048–1.115), attitude scores (OR = 1.079, 95%CI: 1.012–1.149), and department affiliation (internal medicine, pediatrics, or spleen and stomach) (OR = 3.718, 95%CI: 2.132–6.484) were independently associated with the practice. The SEM revealed that knowledge direct positive associations with attitudes (β = 0.336, P < 0.001) and practice (β = 0.396, P < 0.001), and attitudes directly associations with practice (β = 0.301, P < 0.001). Knowledge also showed a significant indirect association with practice through attitudes (β = 0.101, P < 0.001). In conclusion, physicians involved in the management of gastrointestinal disorders in Shanxi, predominantly gastroenterologists and physicians from tertiary hospitals, demonstrate suboptimal knowledge, generally positive attitudes, and suboptimal practices concerning H. pylori antibiotic resistance. These findings highlight the need for targeted educational interventions, particularly among non-gastroenterology physicians and those working outside tertiary centers.