Korean J Gastroenterol.  2013 Jul;62(1):3-26. 10.4166/kjg.2013.62.1.3.

Guidelines for the Diagnosis and Treatment of Helicobacter pylori Infection in Korea, 2013 Revised Edition

• Kim SG
• Jung HK
• Lee HL
• Jang JY
• Lee H
• Kim CG
• Shin WG
• Shin ES
• Lee YC
• Korean College of Helicobacter and Upper Gastrointestinal Research

• KMID: 1711275
• DOI: http://doi.org/10.4166/kjg.2013.62.1.3

Abstract

Since the Korean College of Helicobacter and Upper Gastrointestinal Research has first developed the guideline for the diagnosis and treatment of Helicobacter pylori infection in 1998, the revised guideline was proposed in 2009 by the same group. Although the revised guideline was made by comprehensive review of previous articles and consensus of authoritative expert opinions, the evidence-based developmental process was not applied in the revision of the guideline. This new guideline has been revised especially in terms of changes in the indication and treatment of H. pylori infection in Korea, and developed by the adaptation process as evidence-based method; 6 guidelines were retrieved by systematic review and the Appraisal of Guidelines for Research and Evaluation (AGREE) II process, 21 statements were made with grading system and revised by modified Delphi method. After revision, 11 statements for the indication of test and treatment, 4 statements for the diagnosis and 4 statements for the treatment have been developed, respectively. The revised guideline has been reviewed by external experts before the official endorsement, and will be disseminated for usual clinical practice in Korea. Also, the scheduled update and revision of the guideline will be made periodically.

Keyword

Helicobacter pylori; Guidelines; Diagnosis; Treatment; Adaptation

MeSH Terms

Amoxicillin/therapeutic use
Anti-Bacterial Agents/therapeutic use
Aspirin/therapeutic use
Bismuth/therapeutic use
Breath Tests
Clarithromycin/therapeutic use
Gastroesophageal Reflux/etiology
Gastroscopy
Helicobacter Infections/complications/*diagnosis/drug therapy
*Helicobacter pylori
Humans
Lymphoma, B-Cell, Marginal Zone/complications
Metaplasia/complications
Metronidazole/therapeutic use
Peptic Ulcer/complications/drug therapy
Proton Pump Inhibitors/therapeutic use
Republic of Korea
Stomach Neoplasms/complications/surgery
Tetracycline/therapeutic use
Amoxicillin
Anti-Bacterial Agents
Aspirin
Bismuth
Clarithromycin
Metronidazole
Proton Pump Inhibitors
Tetracycline

Figure

• 

  Fig. 1. Flowchart of study selection.

• 

  Fig. 2. Appraisal results of candidate guidelines by the Appraisal of Guidelines for Research & Evaluation II process (AGREE II). Selected guidelines number: 1, Canadian; 2, American College of Gastroenterology (ACG); 3, Japan; 4, Asian-Pacific (AP); 5, Korean College of Helicobacter and Upper Gastrointestinal Research; 6, Maastricht.

• 

  Fig. 3. Algorithm of Helicobacter pylori eradication. Triple therapy, proton pump inhibitor (PPI) standard dose two times a day (bid), amoxicillin 1 g bid, clarithromycin 500 mg bid for 7–14 days; Bis-muth-based quadruple therapy, PPI standard dose bid, metronidazole 500 mg three times a day (tid), bismuth 120 mg four times a day (qid), tetracycline 500 mg qid for 7–14 days; Regimen including other 2 or more antibiotics, combination with other 2 or more antibiotics except metronidazole and tetracycline which were used in first-line therapy.

Reference

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