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.
Bibliographical noteFunding 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.
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).
© 2022 The Author(s)
All Science Journal Classification (ASJC) codes
- Immunology and Allergy
- Microbiology (medical)