Yang Hyo-Joon, Kim Joon Sung, Ahn Ji Yong, Lee Ok-Jae, Kim Gwang Ha, Bang Chang Seok, Park Moo In, Park Jae Yong, Kim Sun Moon, Hong Su Jin, Cho Joon Hyun, Kim Shin Hee, Song Hyun Joo, Cho Jin Woong, Jee Sam Ryong, Lim Hyun, Kwon Yong Hwan, Lee Ju Yup, Jeon Seong Woo, Park Seon-Young, Choe Younghee, Joo Moon Kyung, Kim Dae-Hyun, Park Jae Myung, Kim Beom Jin, Lee Jong Yeul, Oh Tae Hoon, Kim Jae Gyu
Division of Gastroenterology, Department of Internal Medicine and Gastrointestinal Cancer Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Gut Liver. 2025 May 15;19(3):364-375. doi: 10.5009/gnl240489. Epub 2025 Apr 28.
BACKGROUND/AIMS: The Korean guidelines for 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 infection in Korea.
This interim report describes the adherence to the revised guidelines and their impact on first-line eradication rates. Data on patient demographics, diagnoses, treatments, and eradication outcomes were collected using a web-based electronic case report form.
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).
The revised guidelines for the treatment of 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.
背景/目的：韩国的治疗指南于2020年进行了修订，然而，临床实践中对这些指南的遵循程度仍不明确。在此，我们于2021年启动了一项前瞻性、全国性、多中心注册研究，以评估韩国目前对感染的管理情况。
本中期报告描述了对修订后指南的遵循情况及其对一线根除率的影响。使用基于网络的电子病例报告表收集患者人口统计学、诊断、治疗和根除结果的数据。
共分析了来自66家医院接受一线治疗的7261例患者。一线治疗的改良意向性治疗根除率为81.0%，80.4%的处方遵循修订后的指南。最常用的治疗方案是基于克拉霉素的14天三联疗法（CTT；42.0%），其次是个体化治疗（TT；21.2%）、7天CTT（14.1%）和10天联合疗法（CT；10.1%）。时间趋势分析表明，指南遵循率、10天CT和TT的使用显著增加，同时7天CTT的使用减少（所有p<0.001）。多因素逻辑回归分析显示，指南遵循与一线根除成功显著相关（优势比，2.03；95%置信区间，1.61至2.56；p<0.001）。
韩国修订后的感染治疗指南在日常临床实践中越来越多地被采用，这可能有助于提高一线根除率。值得注意的是，14天CTT、10天CT和TT方案正成为韩国医生首选的一线治疗方案。
