Appropriateness of antibiotic prescriptions during hospitalization and ambulatory care: a multicentre prevalence survey in Korea

the Korea Study Group for Antimicrobial Stewardship (KOSGAP)

doi:10.1016/j.jgar.2022.03.021

Appropriateness of antibiotic prescriptions during hospitalization and ambulatory care: a multicentre prevalence survey in Korea

the Korea Study Group for Antimicrobial Stewardship (KOSGAP)

Internal Medicine

Research output: Contribution to journal › Article › peer-review

10 Citations (Scopus)

Abstract

Objectives: Antimicrobial resistance is one of the most urgent global health threats. The need for the qualitative evaluation of antibiotic use at the national level is increasing. To identify areas for improvement, we aimed to assess the prevalence and appropriateness of antibiotic prescriptions during hospitalization and ambulatory care in Korea. Methods: The prevalence and appropriateness of antibiotic prescriptions on 29 August 2018 were assessed for 20 hospitals in Korea. Infectious disease specialists determined appropriateness. Except for antiviral and anti-tuberculosis agents, all antibacterial or antifungal agent prescriptions during hospitalization or ambulatory care were evaluated. Results: The prevalence of antibiotic prescription was 14.1% (8,400/59 216 patients) on the study date. Antibiotics were prescribed for 50.8% of inpatients (6557/12 902), with two or more antibiotics prescribed for 27.4% (1798/6557) of patients. A total of 10 948 prescriptions (7999 therapeutic, 2105 surgical prophylaxes, and 844 medical prophylaxes) were included in the final analysis, and 27.7% of these were inappropriate. Surgical prophylaxis was inadequately prescribed most frequently (54.4%), followed by medical prophylaxis (29.5%) and therapeutic antibiotics (20.5%). The most common indications for therapeutic antibiotics were respiratory (29.1%, n=2332), gastrointestinal (22.4%, n=1791), and urinary tract infections (13.1%, n=1050). The most frequently prescribed antibiotics were cephalosporins (52.0%, n=5490), followed by beta lactam/beta lactamase inhibitors (13.7%, n=1373), fluoroquinolones (9.1%, n=957), and metronidazole (6.6%, n=699). Conclusion: This was the first nationwide qualitative antibiotic prescription adequacy evaluation in Korea. A significant proportion of antibiotic prescriptions were inappropriate. Therefore, interventions for high-frequency infections and prescription antibiotics are needed.

Original language	English
Pages (from-to)	253-258
Number of pages	6
Journal	Journal of Global Antimicrobial Resistance
Volume	29
DOIs	https://doi.org/10.1016/j.jgar.2022.03.021
Publication status	Published - 2022 Jun

Bibliographical note

Funding Information:
This work was supported by the Research Program funded by the Korea Centers for Disease Control and Prevention, Republic of Korea (grant number 2018-E2802-00). The funders had no role in study design, data collection and analysis, preparation of the manuscript, or the decision to publish.

Funding Information:
This work was supported by the Research Program funded by the Korea Centers for Disease Control and Prevention, Republic of Korea (grant number 2018-E2802-00). The funders had no role in study design, data collection and analysis, preparation of the manuscript, or the decision to publish. None declared. This study was approved by the Institutional Review Board (IRB) of Soonchunhyang University Seoul Hospital (IRB no. 2019-12-016). The authors thank to the following infectious diseases specialists for sharing their knowledge and insights on the subject: Jin Young Kim (Incheon Medical Center), Joon Young Song (Korea University College of Medicine), Joon Sup Yeom (Severance Hospital, Yonsei University College of Medicine), Mi Suk Lee (Kyung Hee University Hospital, Kyung Hee University School of Medicine), Hyunju Lee (Seoul National University Bundang Hospital), Hyun-Ha Chang (Kyungpook National University School of Medicine), Sook-In Jung (Chonnam National University Medical School), and Su-Mi Choi (College of Medicine, The Catholic University). The authors are grateful to the following infectious diseases specialists for their participation in the study: Yoonhee Jun (Cheju Halla General Hospital), Yu Bin Seo (Kangnam Sacred Heart Hospital, Hallym University College of Medicine), Yun Tae Chae (Hanil General Hospital), Dae-Hyuk Heo (DESIGN hospital), Young-Eun Ha (Sejong Hospital, Bucheon), and Sung Jun Jin (Bundang Yonsei Hospital). The authors also thank to the panels of infectious disease specialists who develop guideline of qualitative assessment evaluation guidelines: Shin-Woo Kim (School of Medicine, Kyungpook National University), Youn Jeong Kim (College of Medicine, The Catholic University of Korea), Jin-Won Chung (Chung-Ang University College of Medicine), Chung-Jong Kim (Ewha Womans University College of Medicine), Seong Heon Wie (College of Medicine, The Catholic University), Sang-Oh Lee (University of Ulsan College of Medicine), and Jacob Lee (College of Medicine, Hallym University).

Publisher Copyright:
© 2022 The Author(s)

All Science Journal Classification (ASJC) codes

Microbiology
Immunology and Allergy
Immunology
Microbiology (medical)

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.jgar.2022.03.021

Cite this

@article{917eb0d64c734b53bc12a7ef2e7f6304,

title = "Appropriateness of antibiotic prescriptions during hospitalization and ambulatory care: a multicentre prevalence survey in Korea",

abstract = "Objectives: Antimicrobial resistance is one of the most urgent global health threats. The need for the qualitative evaluation of antibiotic use at the national level is increasing. To identify areas for improvement, we aimed to assess the prevalence and appropriateness of antibiotic prescriptions during hospitalization and ambulatory care in Korea. Methods: The prevalence and appropriateness of antibiotic prescriptions on 29 August 2018 were assessed for 20 hospitals in Korea. Infectious disease specialists determined appropriateness. Except for antiviral and anti-tuberculosis agents, all antibacterial or antifungal agent prescriptions during hospitalization or ambulatory care were evaluated. Results: The prevalence of antibiotic prescription was 14.1% (8,400/59 216 patients) on the study date. Antibiotics were prescribed for 50.8% of inpatients (6557/12 902), with two or more antibiotics prescribed for 27.4% (1798/6557) of patients. A total of 10 948 prescriptions (7999 therapeutic, 2105 surgical prophylaxes, and 844 medical prophylaxes) were included in the final analysis, and 27.7% of these were inappropriate. Surgical prophylaxis was inadequately prescribed most frequently (54.4%), followed by medical prophylaxis (29.5%) and therapeutic antibiotics (20.5%). The most common indications for therapeutic antibiotics were respiratory (29.1%, n=2332), gastrointestinal (22.4%, n=1791), and urinary tract infections (13.1%, n=1050). The most frequently prescribed antibiotics were cephalosporins (52.0%, n=5490), followed by beta lactam/beta lactamase inhibitors (13.7%, n=1373), fluoroquinolones (9.1%, n=957), and metronidazole (6.6%, n=699). Conclusion: This was the first nationwide qualitative antibiotic prescription adequacy evaluation in Korea. A significant proportion of antibiotic prescriptions were inappropriate. Therefore, interventions for high-frequency infections and prescription antibiotics are needed.",

author = "{the Korea Study Group for Antimicrobial Stewardship (KOSGAP)} and Park, {Se Yoon} and Moon, {Song Mi} and Bongyoung Kim and Lee, {Myung Jin} and Park, {Ji Young} and Soyoon Hwang and Yu, {Shi Nae} and Lee, {Yu Mi} and Lee, {Ho Jin} and Hong, {Kyung Wook} and Park, {Kyung Hwa} and Kwak, {Yee Gyung} and Chisook Moon and Jeon, {Min Hyok} and Park, {Sun Hee} and Kim, {Young Keun} and Song, {Kyoung Ho} and Kim, {Eu Suk} and Kim, {Tae Hyong} and Kim, {Hong Bin}",

note = "Funding Information: This work was supported by the Research Program funded by the Korea Centers for Disease Control and Prevention, Republic of Korea (grant number 2018-E2802-00). The funders had no role in study design, data collection and analysis, preparation of the manuscript, or the decision to publish. Funding Information: This work was supported by the Research Program funded by the Korea Centers for Disease Control and Prevention, Republic of Korea (grant number 2018-E2802-00). The funders had no role in study design, data collection and analysis, preparation of the manuscript, or the decision to publish. None declared. This study was approved by the Institutional Review Board (IRB) of Soonchunhyang University Seoul Hospital (IRB no. 2019-12-016). The authors thank to the following infectious diseases specialists for sharing their knowledge and insights on the subject: Jin Young Kim (Incheon Medical Center), Joon Young Song (Korea University College of Medicine), Joon Sup Yeom (Severance Hospital, Yonsei University College of Medicine), Mi Suk Lee (Kyung Hee University Hospital, Kyung Hee University School of Medicine), Hyunju Lee (Seoul National University Bundang Hospital), Hyun-Ha Chang (Kyungpook National University School of Medicine), Sook-In Jung (Chonnam National University Medical School), and Su-Mi Choi (College of Medicine, The Catholic University). The authors are grateful to the following infectious diseases specialists for their participation in the study: Yoonhee Jun (Cheju Halla General Hospital), Yu Bin Seo (Kangnam Sacred Heart Hospital, Hallym University College of Medicine), Yun Tae Chae (Hanil General Hospital), Dae-Hyuk Heo (DESIGN hospital), Young-Eun Ha (Sejong Hospital, Bucheon), and Sung Jun Jin (Bundang Yonsei Hospital). The authors also thank to the panels of infectious disease specialists who develop guideline of qualitative assessment evaluation guidelines: Shin-Woo Kim (School of Medicine, Kyungpook National University), Youn Jeong Kim (College of Medicine, The Catholic University of Korea), Jin-Won Chung (Chung-Ang University College of Medicine), Chung-Jong Kim (Ewha Womans University College of Medicine), Seong Heon Wie (College of Medicine, The Catholic University), Sang-Oh Lee (University of Ulsan College of Medicine), and Jacob Lee (College of Medicine, Hallym University). Publisher Copyright: {\textcopyright} 2022 The Author(s)",

year = "2022",

month = jun,

doi = "10.1016/j.jgar.2022.03.021",

language = "English",

volume = "29",

pages = "253--258",

journal = "Journal of Global Antimicrobial Resistance",

issn = "2213-7165",

publisher = "Elsevier BV",

}

TY - JOUR

T1 - Appropriateness of antibiotic prescriptions during hospitalization and ambulatory care

T2 - a multicentre prevalence survey in Korea

AU - the Korea Study Group for Antimicrobial Stewardship (KOSGAP)

AU - Park, Se Yoon

AU - Moon, Song Mi

AU - Kim, Bongyoung

AU - Lee, Myung Jin

AU - Park, Ji Young

AU - Hwang, Soyoon

AU - Yu, Shi Nae

AU - Lee, Yu Mi

AU - Lee, Ho Jin

AU - Hong, Kyung Wook

AU - Park, Kyung Hwa

AU - Kwak, Yee Gyung

AU - Moon, Chisook

AU - Jeon, Min Hyok

AU - Park, Sun Hee

AU - Kim, Young Keun

AU - Song, Kyoung Ho

AU - Kim, Eu Suk

AU - Kim, Tae Hyong

AU - Kim, Hong Bin

N1 - Funding Information: This work was supported by the Research Program funded by the Korea Centers for Disease Control and Prevention, Republic of Korea (grant number 2018-E2802-00). The funders had no role in study design, data collection and analysis, preparation of the manuscript, or the decision to publish. Funding Information: This work was supported by the Research Program funded by the Korea Centers for Disease Control and Prevention, Republic of Korea (grant number 2018-E2802-00). The funders had no role in study design, data collection and analysis, preparation of the manuscript, or the decision to publish. None declared. This study was approved by the Institutional Review Board (IRB) of Soonchunhyang University Seoul Hospital (IRB no. 2019-12-016). The authors thank to the following infectious diseases specialists for sharing their knowledge and insights on the subject: Jin Young Kim (Incheon Medical Center), Joon Young Song (Korea University College of Medicine), Joon Sup Yeom (Severance Hospital, Yonsei University College of Medicine), Mi Suk Lee (Kyung Hee University Hospital, Kyung Hee University School of Medicine), Hyunju Lee (Seoul National University Bundang Hospital), Hyun-Ha Chang (Kyungpook National University School of Medicine), Sook-In Jung (Chonnam National University Medical School), and Su-Mi Choi (College of Medicine, The Catholic University). The authors are grateful to the following infectious diseases specialists for their participation in the study: Yoonhee Jun (Cheju Halla General Hospital), Yu Bin Seo (Kangnam Sacred Heart Hospital, Hallym University College of Medicine), Yun Tae Chae (Hanil General Hospital), Dae-Hyuk Heo (DESIGN hospital), Young-Eun Ha (Sejong Hospital, Bucheon), and Sung Jun Jin (Bundang Yonsei Hospital). The authors also thank to the panels of infectious disease specialists who develop guideline of qualitative assessment evaluation guidelines: Shin-Woo Kim (School of Medicine, Kyungpook National University), Youn Jeong Kim (College of Medicine, The Catholic University of Korea), Jin-Won Chung (Chung-Ang University College of Medicine), Chung-Jong Kim (Ewha Womans University College of Medicine), Seong Heon Wie (College of Medicine, The Catholic University), Sang-Oh Lee (University of Ulsan College of Medicine), and Jacob Lee (College of Medicine, Hallym University). Publisher Copyright: © 2022 The Author(s)

PY - 2022/6

Y1 - 2022/6

N2 - Objectives: Antimicrobial resistance is one of the most urgent global health threats. The need for the qualitative evaluation of antibiotic use at the national level is increasing. To identify areas for improvement, we aimed to assess the prevalence and appropriateness of antibiotic prescriptions during hospitalization and ambulatory care in Korea. Methods: The prevalence and appropriateness of antibiotic prescriptions on 29 August 2018 were assessed for 20 hospitals in Korea. Infectious disease specialists determined appropriateness. Except for antiviral and anti-tuberculosis agents, all antibacterial or antifungal agent prescriptions during hospitalization or ambulatory care were evaluated. Results: The prevalence of antibiotic prescription was 14.1% (8,400/59 216 patients) on the study date. Antibiotics were prescribed for 50.8% of inpatients (6557/12 902), with two or more antibiotics prescribed for 27.4% (1798/6557) of patients. A total of 10 948 prescriptions (7999 therapeutic, 2105 surgical prophylaxes, and 844 medical prophylaxes) were included in the final analysis, and 27.7% of these were inappropriate. Surgical prophylaxis was inadequately prescribed most frequently (54.4%), followed by medical prophylaxis (29.5%) and therapeutic antibiotics (20.5%). The most common indications for therapeutic antibiotics were respiratory (29.1%, n=2332), gastrointestinal (22.4%, n=1791), and urinary tract infections (13.1%, n=1050). The most frequently prescribed antibiotics were cephalosporins (52.0%, n=5490), followed by beta lactam/beta lactamase inhibitors (13.7%, n=1373), fluoroquinolones (9.1%, n=957), and metronidazole (6.6%, n=699). Conclusion: This was the first nationwide qualitative antibiotic prescription adequacy evaluation in Korea. A significant proportion of antibiotic prescriptions were inappropriate. Therefore, interventions for high-frequency infections and prescription antibiotics are needed.

AB - Objectives: Antimicrobial resistance is one of the most urgent global health threats. The need for the qualitative evaluation of antibiotic use at the national level is increasing. To identify areas for improvement, we aimed to assess the prevalence and appropriateness of antibiotic prescriptions during hospitalization and ambulatory care in Korea. Methods: The prevalence and appropriateness of antibiotic prescriptions on 29 August 2018 were assessed for 20 hospitals in Korea. Infectious disease specialists determined appropriateness. Except for antiviral and anti-tuberculosis agents, all antibacterial or antifungal agent prescriptions during hospitalization or ambulatory care were evaluated. Results: The prevalence of antibiotic prescription was 14.1% (8,400/59 216 patients) on the study date. Antibiotics were prescribed for 50.8% of inpatients (6557/12 902), with two or more antibiotics prescribed for 27.4% (1798/6557) of patients. A total of 10 948 prescriptions (7999 therapeutic, 2105 surgical prophylaxes, and 844 medical prophylaxes) were included in the final analysis, and 27.7% of these were inappropriate. Surgical prophylaxis was inadequately prescribed most frequently (54.4%), followed by medical prophylaxis (29.5%) and therapeutic antibiotics (20.5%). The most common indications for therapeutic antibiotics were respiratory (29.1%, n=2332), gastrointestinal (22.4%, n=1791), and urinary tract infections (13.1%, n=1050). The most frequently prescribed antibiotics were cephalosporins (52.0%, n=5490), followed by beta lactam/beta lactamase inhibitors (13.7%, n=1373), fluoroquinolones (9.1%, n=957), and metronidazole (6.6%, n=699). Conclusion: This was the first nationwide qualitative antibiotic prescription adequacy evaluation in Korea. A significant proportion of antibiotic prescriptions were inappropriate. Therefore, interventions for high-frequency infections and prescription antibiotics are needed.

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Appropriateness of antibiotic prescriptions during hospitalization and ambulatory care: a multicentre prevalence survey in Korea

Abstract

Bibliographical note

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UN SDGs

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