Antibiotic use in South Korea from 2007 to 2014: A health insurance database-generated time series analysis

Abstract

BackgroundInappropriate antibiotic use significantly contributes to antibiotic-resistance, resulting in reduced antibiotic efficacy and increasing physical burden and cost of disease. The goal of this study was to explore antibiotic usage patterns in South Korea using 2007–2014 health insurance claims data.MethodsWe used the Health Insurance Review & Assessment Service data, which represents nearly the entire population of South Korea, to discern patterns in antibiotic prescribing practices. The daily dose, as defined by the World Health Organization ([defined daily doses]/1000 inhabitants/day, [DID]), was used as a measure of antibiotic use. Subgroup analyses were performed on the basis of patient characteristics (sex, age, and disease) and provider characteristics (type of medical institution).ResultsAntibiotic use in DID increased from 23.5 in 2007 to 27.7 in 2014. The ≤ 6 years old age group showed the highest level of usage at 59.21 DID in 2014, and showed an increasing trend each year. DIDs of beta-lactam antibacterials, penicillins (J01C), other beta-lactam antibacterials (J01D), lincosamides and streptogramins (J01F), quinolone antibacterials (J01M), and other antibacterials (J01X) increased over time.ConclusionThis study provides valuable statistics regarding antibiotic usage in South Korea; this is important for guiding health policy with regard to antibiotic usage. There is a need for further study exploring antibiotics use and resistance.

Increased use of third‐generation cephalosporin antibiotics in the outpatient setting in Korean children and adolescents

“…In particular, the use (DDD/1,000 patients/day) of cefpodoxime, a third‐generation cephalosporin, increased twofold from 2010 to 2014. This is in line with previous studies that noted increases in the use of third‐generation cephalosporins in Korea . These broad spectrum antibiotics are usually recommended for inpatients with community‐acquired pneumonia, but there is no clear explanation as to why the use of third‐generation cephalosporins increased in the outpatient setting; we cannot rule out, however, the possibility of strong sales and promotion of newer antibiotics by the pharmaceutical industry.…”

Nationwide antibiotic resistance mapping of Helicobacter pylori in Korea: A prospective multicenter study

“…The H. pylori eradication rates with quinolone‐containing regimens in Korea have been disappointing in terms of first‐line or third‐line therapies . Quinolone usage based on Korean insurance data was increased from 2007 to 2014, but these antibiotics seem now to be inappropriate as a first‐line H. pylori eradication regimen.…”

Antimicrobial Stewardship Programs in Community Health Systems Perceived by Physicians and Pharmacists: A Qualitative Study with Gap Analysis

“…During the interviews, ID physicians also expressed that ID consults were sometimes disregarded and were requested late. Unfortunately, this meant that ID consults were often pointless (phy6- [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. ID physicians believed that their roles were limited in the approval of restricted antimicrobial agents.…”

“…ⓐProspective audit with direct intervention and feedback (7,3) ⓒEducation (0,3) ⓓEvidence-based guidelines and clinical pathways (1,1) ⓔAntimicrobial cycling (0,1) ⓕAntimicrobial order forms (0,1) ⓖCombination therapy (0,2) ⓗStreamlining or de-escalation of therapy (5,4) ⓘDose optimization (3,2) ⓙParenteral-to-oral conversion (2,3)…”

“…Meanwhile, multidrug resistance is a growing threat to public health and an emerging crisis [5]. The level of antibiotic usage in South Korea (28 defined daily doses [DDD] per 1000 inhabitants per day [DID]) is still much higher than the average for other Organisation for Economic Co-operation and Development (OECD) countries (18 DID) as of 2012 [6,7]. According to the Korea ASP survey in 2015, the number of infectious disease (ID) specialists increased from previous surveys in 2006 and 2012, but the proportion of hospitals operating ASP did not increase; ASP were limited to top-tier general hospitals [8].…”