Prescriptions patterns and appropriateness of usage of antibiotics in non-teaching community hospitals in South Korea: a multicentre retrospective study

Abstract

Background Although non-teaching community hospitals form the majority of healthcare providers in South Korea, there is limited data on antibiotic usage in them. To evaluate the pattern of antibiotic usage and its appropriateness in hospitals with < 400 beds in South Korea. Methods A multicentre retrospective study was conducted in 10 hospitals (six long-term care hospitals, three acute care hospitals, and one orthopaedic hospital), with < 400 beds in South Korea. We analysed patterns of antibiotic prescription in 2019, and their appropriateness in the participating hospitals. For the evaluation of the appropriateness of the prescription, 25 patients under antibiotic therapy were randomly selected at each hospital, over two separate periods. Due to the heterogeneity of their characteristics, the orthopaedics hospital was excluded from the analysis. Results The most commonly prescribed antibiotics in long-term care hospitals was fluoroquinolone, followed by beta-lactam/beta-lactamase inhibitor (anti-pseudomonal). In acute care hospitals, these were third generation cephalosporin, followed by first generation cephalosporin, and second generation cephalosporin. The major antibiotics that were prescribed in the orthopedics hospital was first generation cephalosporin Only 2.3% of the antibiotics were administered inappropriately. In comparison, 15.3% of patients were prescribed an inappropriate dose. The proportion of inappropriate antibiotic prescriptions was 30.6% of the total antibiotic prescriptions. Conclusions The antibiotic usage patterns vary between non-teaching community hospitals in South Korea. The proportion of inappropriate prescriptions exceeded 30% of the total antibiotic prescriptions.

Core Elements for Implementing Antimicrobial Stewardship Programs in Korean General Hospitals

“…Considering the difference in human resources and financial capacity of each facility, even in tertiary hospitals at the same level, each core element is refined for appropriate application, even at medical facilities with limited resources. Considering the high antimicrobial prescription and inappropriate antimicrobial prescription rates [ 135 ] at primary or secondary hospitals, and the high detection rate of antimicrobial-resistant bacteria at primary, secondary, and long-term care facilities, preparing separate guidelines for core elements of small- and medium-sized hospitals and clinics in the long term may be necessary.…”

Current Status and Prospect of Qualitative Assessment of Antibiotics Prescriptions

“…According to the results of domestic and foreign studies on the qualitative assessment of antibiotics prescriptions since the 2000s, it was found that approximately 20 - 55% of all antibiotics prescriptions were inappropriate [ 15 16 17 18 ]. In a survey of domestic secondary and tertiary medical institutions, approximately 25% of all antibiotics prescriptions were found to be inappropriate, and a survey of small- and medium-sized hospitals showed that approximately 35% of all antibiotics prescriptions were inappropriate [ 15 16 ].…”

“…According to the results of domestic and foreign studies on the qualitative assessment of antibiotics prescriptions since the 2000s, it was found that approximately 20 - 55% of all antibiotics prescriptions were inappropriate [ 15 16 17 18 ]. In a survey of domestic secondary and tertiary medical institutions, approximately 25% of all antibiotics prescriptions were found to be inappropriate, and a survey of small- and medium-sized hospitals showed that approximately 35% of all antibiotics prescriptions were inappropriate [ 15 16 ]. Although it is difficult to directly compare the results of different countries because of the lack of globally standardized assessment methods or cycles, and infectious diseases or antibiotics included in assessment varies from country-to-country, approximately 25% of all antibiotics prescriptions in Australia and approximately 55% in the United States were presumed to be inappropriate [ 17 18 ].…”

“…In Korea, qualitative assessment of antibiotics prescriptions has been performed sporadically in some institutions since the early 2000s [ 15 16 41 42 43 44 ]. In 2003, qualitative assessment of the use of intravenous ciprofloxacin was conducted at eight domestic hospitals, and during 2006 - 2008, qualitative assessment of the use of antibiotics for surgical prophylaxis was conducted at six hospitals [ 41 42 ].…”

“…In addition, in 2021, a qualitative assessment of antibiotics was conducted for 10 small- and medium-sized hospitals with less than 400 beds across the country. From the survey, it was confirmed that 34.2% of the antibiotics prescribed for inpatients at acute care small- and medium-sized hospitals and 36.7% of antibiotics prescribed to inpatients at long-term care hospitals were inappropriate [ 16 ].…”