A survey on the clinical practice and the guidelines for sexually transmitted infections in Korea

Hyun-Sop Choe; Seung-Ju Lee; Dong Hoon Lim; Yong-Hyun Cho; Chul Sung Kim

doi:10.5124/jkma.2010.53.11.1028

J Korean Med Assoc > Volume 53(11); 2010 > Article

Choe, Lee, Lim, Cho, and Kim: A survey on the clinical practice and the guidelines for sexually transmitted infections in Korea

Original Article

Journal of the Korean Medical Association

Journal of the Korean Medical Association 2010; 53(11): 1028-1036.

Published online: November 15, 2010

DOI: http://dx.doi.org/10.5124/jkma.2010.53.11.1028

A survey on the clinical practice and the guidelines for sexually transmitted infections in Korea

Hyun-Sop Choe, MD¹, Seung-Ju Lee, MD¹, Dong Hoon Lim, MD², Yong-Hyun Cho, MD³, Chul Sung Kim, MD²

¹Department of Urology, The Catholic University of Korea, St. Vincent's Hospital, Suwon, Korea.

²Department of Urology, Chosun University College of Medicine, Gwangju, Korea.

³Department of Urology, The Catholic University of Korea, St. Mary's Hospital, Seoul, Korea.

Corresponding author: Chul Sung Kim, cskim@chosun.ac.kr

Received July 23, 2010 Accepted September 13, 2010

This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Every year 150 million new cases of sexually transmitted infection are expected to occur around the world with high occurrence and morbidity rates in both males and females. To respond to dramatically changing social and cultural environments, clinical treatment guidelines for diagnosis, treatment, and prevention of sexually transmitted infections have been developed in many countries, and South Korea has also prepared treatment guidelines which can be used in medical institutions treating primarily these diseases. Against this background, this study conducted a 31-item questionnaire survey by mail and e-mail to investigate the actual clinical practices of physicians treating sexually transmitted infections. In total, 250 and 1,068 questionnaires were distributed through mail and e-mail, respectively, and 274 of them were completed and returned for a response rate of 20.8%. According to the results, physicians' actual clinical practices were found to be different from textbook guidelines to some degree. Therefore, treatment guidelines that take into account the current situation for sexually transmitted infections should be developed in Korea, and a foundation for national management of the diseases should be established through active advertisements.

Sexually transmitted infection; Guideline; Questionnaire survey

References

1. Guidelines for management of sexually transmitted infection [Internet] 2008;cited 2009 June 15. Seoul: Korean Center for Disease Control and Prevention. Available from: http://www.cdc.go.kr/kcdchome/FileDownload.do?file=/board/582/2008081917574734_20904_0.hwp

2. Workowski KA, Berman SM. Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2006. MMWR Recomm Rep 2006;55:1-94.

3. Ratnam S. The laboratory diagnosis of syphilis. Can J Infect Dis Med Microbiol 2005;16:45-51.

4. Lukehart SA. Serologic testing after therapy for syphilis: is there a test for cure? Ann Intern Med 1991;114:1057-1058.

5. Elliott WC. Treatment of primary syphilis. J Am Vener Dis Assoc 1976;3(2 Pt 2):128-135.

6. Idsoe O, Guthe T, Willcox RR. Penicillin in the treatment of syphilis: the experience of three decades. Bull World Health Organ 1972;47:Suppl. 1-68.

7. Rolfs RT, Joesoef MR, Hendershot EF, Rompalo AM, Augenbraun MH, Chiu M, Bolan G, Johnson SC, French P, Steen E, Radolf JD, Larsen S. The Syphilis and HIV Study Group. A randomized trial of enhanced therapy for early syphilis in patients with and without human immunodeficiency virus infection. N Engl J Med 1997;337:307-314.

8. Gaydos CA, Quinn TC. Urine nucleic acid amplification tests for the diagnosis of sexually transmitted infections in clinical practice. Curr Opin Infect Dis 2005;18:55-66.

9. Bloomfield PJ, Steiner KC, Kent CK, Klausner JD. Repeat chlamydia screening by mail, San Francisco. Sex Transm Infect 2003;79:28-30.

10. Johnson RE, Newhall WJ, Papp JR, Knapp JS, Black CM, Gift TL, Steece R, Markowitz LE, Devine OJ, Walsh CM, Wang S, Gunter DC, Irwin KL, DeLisle S, Berman SM. Screening tests to detect Chlamydia trachomatis and Neisseria gonorrhoeae infections--2002. MMWR Recomm Rep 2002;51:1-38.

11. Tapsall JW, Limnios EA, Abu Bakar HM, Darussalam B, Ping YY, Buadromo EM, Kumar P, Singh S, Lo J, Bala M, Risbud A, Deguchi T, Tanaka M, Watanabe Y, Lee K, Chong Y, Noikaseumsy S, Phouthavane T, Sam IC, Tundev O, Lwin KM, Eh PH, Goarant C, Goursaud R, Bathgate T, Brokenshire M, Latorre L, Velemu E, Carlos C, Leano S, Telan EO, Goh SS, Koh ST, Ngan C, Tan AL, Mananwatte S, Piyanoot N, Lokpichat S, Sirivongranson P, Fakahau M, Sitanilei H, Hung le V. Surveillance of antibiotic resistance in Neisseria gonorrhoeae in the WHO Western Pacific and South East Asian regions 2007-2008. Commun Dis Intell 2010;34:1-7.

12. Yong D, Kim TS, Choi JR, Yum JH, Lee K, Chong Y, Oh HB, Shultz T, Tapsall JW. Epidemiological characteristics and molecular basis of fluoroquinolone-resistant Neisseria gonorrhoeae strains isolated in Korea and nearby countries. J Antimicrob Chemother 2004;54:451-455.

13. Yoo J, Yoo C, Cho Y, Park H, Oh HB, Seong WK. Antimicrobial resistance patterns (1999-2002) and characterization of ciprofloxacin-resistant Neisseria gonorrhoeae in Korea. Sex Transm Dis 2004;31:305-310.

14. Bodsworth NJ, Crooks RJ, Borelli S, Vejlsgaard G, Paavonen J, Worm AM, Uexkull N, Esmann J, Strand A, Ingamells AJ, Gibb A. International Valaciclovir HSV Study Group. Valaciclovir versus aciclovir in patient initiated treatment of recurrent genital herpes: a randomised, double blind clinical trial. Genitourin Med 1997;73:110-116.

15. Chosidow O, Drouault Y, Leconte-Veyriac F, Aymard M, Ortonne JP, Pouget F, Revuz J, Decazes JM, Malkin JE. Famciclovir vs. aciclovir in immunocompetent patients with recurrent genital herpes infections: a parallel-groups, randomized, double-blind clinical trial. Br J Dermatol 2001;144:818-824.

16. Fife KH, Barbarash RA, Rudolph T, Degregorio B, Roth R. The Valaciclovir International Herpes Simplex Virus Study Group. Valaciclovir versus acyclovir in the treatment of first-episode genital herpes infection. Results of an international, multicenter, double-blind, randomized clinical trial. Sex Transm Dis 1997;24:481-486.

17. Diaz-Mitoma F, Sibbald RG, Shafran SD, Boon R, Saltzman RL. Collaborative Famciclovir Genital Herpes Research Group. Oral famciclovir for the suppression of recurrent genital herpes: a randomized controlled trial. JAMA 1998;280:887-892.

18. Gross G, Ikenberg H, Gissmann L, Hagedorn M. Papillomavirus infection of the anogenital region: correlation between histology, clinical picture, and virus type. Proposal of a new nomenclature. J Invest Dermatol 1985;85:147-152.

19. Franco EL, Duarte-Franco E, Ferenczy A. Cervical cancer: epidemiology, prevention and the role of human papillomavirus infection. CMAJ 2001;164:1017-1025.

20. Koutsky LA, Galloway DA, Holmes KK. Epidemiology of genital human papillomavirus infection. Epidemiol Rev 1988;10:122-163.

21. Chuang TY, Perry HO, Kurland LT, Ilstrup DM. Condyloma acuminatum in Rochester, Minn., 1950-1978. I. Epidemiology and clinical features. Arch Dermatol 1984;120:469-475.

22. Silverberg MJ, Ahdieh L, Munoz A, Anastos K, Burk RD, Cu-Uvin S, Duerr A, Greenblatt RM, Klein RS, Massad S, Minkoff H, Muderspach L, Palefsky J, Piessens E, Schuman P, Watts H, Shah KV. The impact of HIV infection and immunodeficiency on human papillomavirus type 6 or 11 infection and on genital warts. Sex Transm Dis 2002;29:427-435.

23. Simmons PD, Langlet F, Thin RN. Cryotherapy versus electrocautery in the treatment of genital warts. Br J Vener Dis 1981;57:273-274.

24. Abdullah AN, Walzman M, Wade A. Treatment of external genital warts comparing cryotherapy (liquid nitrogen) and trichloroacetic acid. Sex Transm Dis 1993;20:344-345.

25. Tyring SK, Arany I, Stanley MA, Tomai MA, Miller RL, Smith MH, McDermott DJ, Slade HB. A randomized, controlled, molecular study of condylomata acuminata clearance during treatment with imiquimod. J Infect Dis 1998;178:551-555.

26. Kirby P, Dunne A, King DH, Corey L. Double-blind randomized clinical trial of self-administered podofilox solution versus vehicle in the treatment of genital warts. Am J Med 1990;88:465-469.

Table 1

Characteristics of participants (n=274)

Table 2

Preference on the guidelines of STIs

STI, sexually transmitted infection; KCDC, Korea Centers for Disease Control and Prevention; CDC, Centers for Disease Control and Prevention

Table 3

Preference on the syphilis

VDRL, venerial disease research laboratory slide test; RPR, rapid Plasma Reagin test; TPHA, Treponema Pallidum Haemagglutination Assay; FTA-ABS, fluorescent treponema antibody-absorption test; Sx., symptom; IM, intramuscular; IV, intravenous

Table 4

Preference on the urethritis or cervicitis

NAAT, nucleic acid amplification test; PCR, polymerase chain reaction; SDA, strand displacement amplification; TMA, transcription mediated amplification