Trend of Antibiotic Use in Children with Acute Otitis Media in Korea

Abstract

Public interventions have shown to optimize the use of antibiotics in children with acute otitis media (AOM). In this study, we describe the AOM-related antibiotic use among children in South Korea using national cohort data. We retrieved the Health Insurance Review & Assessment Service data to construct a national cohort of children aged 0–6 years who had been diagnosed with AOM between 2012 and 2018. Of 25,212,264 children included, the antibiotic prescription has increased for amoxicillin/amoxicillin-clavulanate from 56.1% in 2012 to 61.8% in 2018. Prescription has decreased for cephalosporin (35.1% in 2012 to 31.8% in 2018) and macrolide (8.7% in 2012 to 6.4% in 2018). National cohort data have shown an increased trend in AOM-related aminopenicillin prescription and downward trend cephalosporin and macrolide use in South Korea. A multi-faceted approach is required to control the antimicrobial resistance at a population level.

Watchful Waiting in Pediatric Acute Otitis Media: A Real Practice Approach or an Intangible Desideratum?

“…Yamaguchi et al reported only a slight increase in amoxicillin use in Japan, from 24% throughout the study (2012 to 2018) period to 28.9% in 2018 [ 16 ]. Although analyzing a substantial population sample of more than 25 million children, the report from Korea does not separate amoxicillin from amoxicillin/clavulanic acid and reports a slight increase of 5.7% in the use of both antimicrobials in 2018 compared to 2012 [ 11 ]. However, the use of cephalosporins decreased, from 3.3% at the end of a 7-year period in the study from Korea [ 11 ] to 28.4% at the end of a 4-year period in the study from France [ 17 ].…”

“…Although analyzing a substantial population sample of more than 25 million children, the report from Korea does not separate amoxicillin from amoxicillin/clavulanic acid and reports a slight increase of 5.7% in the use of both antimicrobials in 2018 compared to 2012 [ 11 ]. However, the use of cephalosporins decreased, from 3.3% at the end of a 7-year period in the study from Korea [ 11 ] to 28.4% at the end of a 4-year period in the study from France [ 17 ]. In Italy, no significant improvement in the antibiotic prescription rate and in amoxicillin use was observed after the introduction of the guidelines [ 18 ].…”

“…The fluoroquinolones are not included in the recommended group of antibiotics in any of the guidelines. After analyzing the guidelines’ recommendations, the following observations can be made: The high rate of cephalosporins use reported by Park et al in Korea [ 11 ] is not justified by the guidelines, as this class of antibiotics is reserved only for children with non-type I hypersensitivity. Furthermore, macrolides are recommended only for children with a history of type I hypersensitivity reaction to penicillin (e.g., urticaria, anaphylaxis).…”

“…Moreover, the regimen duration reported in Spain [ 16 ] respected the indications of the local guidelines. The report from Israel [ 11 ] revealed the highest rate of azithromycin use, which is recommended by the local guidelines only in cases of major penicillin allergy. As the cephalosporins do not seem to be recommended at all, 48%–54% of AOM episodes were inappropriately treated, against the guideline recommendations.…”

Constructing nano SiO2‐anchored hyperbranched polymer hybrid architectures for thermosetting epoxy systems with outstanding mechanical property

“…Second, CHBPE-SiO 2 has good compatibility with EP, the addition of CHBPE-SiO 2 can increase the reactivity of EP and create the strong interface interaction between CHBPE-SiO 2 and EP matrix. As shown in Figure 6A, EP/CHBPE-SiO 2 has a new lower and wide exothermic peak at about 180 C compared to EP, and EP/DDS/CHBPE-SiO 2 has a lower exothermic peak temperature (219 C) than EP/DDS (245 C), which indicate that CHBPE-SiO 2 can accelerate the polymerization of EP resulting from the reaction between COOH-terminated CHBPE and epoxy groups, [46,63] thus enhancing the α epoxy group (Figures 6B and S7) and the strong interface interaction between CHBPE-SiO 2 and EP matrix. Therefore, the mechanical property of EP can be improved.…”