Gut Liver.  2025 May;19(3):364-375. 10.5009/gnl240489.

Korean Registry on the Current Management of Helicobacter pylori (K-Hp-Reg): Interim Analysis of Adherence to the Revised Evidence-Based Guidelines for First-Line Treatment

• Yang HJ
• Kim JS
• Ahn JY
• Lee OJ
• Kim GH
• Bang CS
• Park MI
• Park JY
• Kim SM
• Hong SJ
• Cho JH
• Kim SH
• Song HJ
• Cho JW
• Jee SR
• Lim H
• Kwon YH
• Lee JY
• Jeon SW
• Park SY
• Choe Y
• Joo MK
• Kim DH
• Park JM
• Kim BJ
• Lee JY
• Oh TH
• Kim JG
• Korean College of Helicobacter and Upper Gastrointestinal Research

• KMID: 2568164
• DOI: http://doi.org/10.5009/gnl240489

Abstract

Background/Aims
The Korean guidelines for Helicobacter pylori treatment were revised in 2020, however, the extent of adherence to these guidelines in clinical practice remains unclear. Herein, we initiated a prospective, nationwide, multicenter registry study in 2021 to evaluate the current management of H. pylori infection in Korea.
Methods
This interim report describes the adherence to the revised guidelines and their impact on firstline eradication rates. Data on patient demographics, diagnoses, treatments, and eradication outcomes were collected using a web-based electronic case report form.
Results
A total of 7,261 patients from 66 hospitals who received first-line treatment were analyzed. The modified intention-to-treat eradication rate for first-line treatment was 81.0%, with 80.4% of the prescriptions adhering to the revised guidelines. The most commonly prescribed regimen was the 14-day clarithromycin-based triple therapy (CTT; 42.0%), followed by tailored therapy (TT; 21.2%), 7-day CTT (14.1%), and 10-day concomitant therapy (CT; 10.1%). Time-trend analysis demonstrated significant increases in guideline adherence and the use of 10-day CT and TT, along with a decrease in the use of 7-day CTT (all p<0.001). Multivariate logistic regression analysis revealed that guideline adherence was significantly associated with first-line eradication success (odds ratio, 2.03; 95% confidence interval, 1.61 to 2.56; p<0.001).
Conclusions
The revised guidelines for the treatment of H. pylori infection have been increasingly adopted in routine clinical practice in Korea, which may have contributed to improved first-line eradication rates. Notably, the 14-day CTT, 10-day CT, and TT regimens are emerging as the preferred first-line treatment options among Korean physicians.

Keyword

Helicobacter pylori; Anti-bacterial agents; Drug resistance, bacterial; Registries; Guideline adherence