Korean J Med.  2021 Jun;96(3):160-189. 10.3904/kjm.2021.96.3.160.

Evidence-Based Guidelines for the Treatment of Helicobacter pylori Infection in Korea: 2020 Revised Edition

Affiliations
  • 1Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul, Korea
  • 2Department of Internal Medicine, Seoul National University Hospital Gangnam Center, Seoul, Korea
  • 3Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
  • 4Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
  • 5Division of Gastroenterology, Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Korea
  • 6Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
  • 7Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
  • 8Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea
  • 9Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
  • 10Division of Gastroenterology, Department of Internal Medicine, Kyungpook National University Hospital Chilgok Hospital, Daegu, Korea
  • 11Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea
  • 12Department of Internal Medicine, St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
  • 13Center for Gastric Cancer, National Cancer Center, Goyang, Korea
  • 14Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea
  • 15Division of Healthcare Technology Assessment Research, National Evidence-based Healthcare Collaborating Agency, Seoul, Korea

Abstract

Helicobacter pylori (H. pylori) infection is one of the most common infectious diseases worldwide. Although its incidence is gradually decreasing, about half of the world's population still get infected. H. pylori infection is responsible for substantial gastrointestinal morbidity worldwide. It is the most common cause of gastric and duodenal ulcers as well as gastric cancer. Since the revision of the H. pylori Clinical Practice Guidelines in 2013, the eradication rate of H. pylori has gradually decreased with the use of classical triple therapy, wherein amoxicillin, clarithromycin, and proton pump inhibitors are administered, for 7 days. According to a nationwide randomized controlled study conducted by the Korean College of Helicobacter and Upper Gastrointestinal Research released in 2018, the intention-to-treat eradication rate was only 63.9%, which was due to increased antimicrobial resistance induced by the use of antibiotics, especially clarithromycin. The update of clinical practice guideline for treatment of H. pylori was developed based on evidence-based medicine by conducting a meta-analysis. The draft recommendations were finalized after expert consensus on three recommendations regarding the indication for treatment and eight recommendations on the treatment itself. These guidelines are designed to provide patients, nurses, medical school students, policymakers, and clinicians with clinical evidence to guide primary care and treatment of H. pylori infection. These may differ from current medical insurance standards and will be revised further, if necessary, based on research-based evidence.

Keyword

Evidence-based medicine; Guideline; Helicobacter pylori; Meta-analysis; Treatment
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