AIM: To evaluate the attitude of primary care physicians in the diagnosis and treatment of Helicobacter pylori (H pylori) infection.METHODS: Primary care physicians in the Seoul metropolitan area answered self-administered questionnaire from January to March 2003.RESULTS: One hundred and eight doctors responded to the questionnaire. The most frequent reasons for testing H pylori infection were gastric and duodenal ulcers (93.5% and 88.9%, respectively). For patients with H plori positive dyspepsia, 28.7% of doctors always tried to eradicate the worm and 34.4% treated selectively.A large proportion (28.7%) of primary care physicians treated H pylori on a patients request basis. Only 9.3%of primary care physicians always conducted follow-up testing after treating H pylori infection. When H pylori was not cleared by the first treatment, 40.7% of doctors reused the same regimen, 16.7% changed to another triple regimen and 25% to a quadruple regimen.CONCLUSION: It has been well documented that the issuance of guidelines alone has little impact on practice.Communication between primary care physicians and gastroenterologists in the form of continuous medical education is required.