Trend of antibiotics usage for acute pyelonephritis in Korea based on national health insurance data 2010–2014

Abstract

Background The objective of this study is to describe the changes in prescribing practices of antibiotics to treat acute pyelonephritis (APN) in Korea. Methods The claim data base of the Health Insurance Review and Assessment Service in Korea was used to select patients with ICD-10 codes N10 (acute tubulo-interstitial nephritis) or N12 (tubulo-interstitial nephritis, not specified as acute nor chronic) as the primary discharge diagnosis during 2010–2014. Consumption of each class of antibiotics was converted to Defined Daily Dose (DDD)/event. Results Throughout the five-year period, the average antibiotic consumption were 11.3 DDD per inpatient event and 6.0 DDD per outpatient event. The annual average antibiotic consumption increased for inpatients ( P = 0.002), but remained stable for outpatients ( P = 0.066). The use of parenteral antibiotics increased for inpatients ( P < 0.001), but decreased for outpatients ( P = 0.017). As for the the antibiotic classes, 3 rd generation cephalosporins (3 rd CEPs) was the most commonly prescribed (41.4%) for inpatients, followed by fluoroquinolones (FQs) (28.5%); for outpatient, FQs (54.8%) was the most commonly prescribed, followed by 3 rd CEPs (13.1%). The use of 3 rd CEPs ( P < 0.001), beta-lactam/beta-lactamase inhibitors ( P = 0.007), and carbapenems ( P < 0.001) increased substantially for the treatment of hospitalized APN patients. In particular, carbapenems use increased 3.1-fold over the 5 years. Conclusions Prescription of broad-spectrum antibiotics increased much for the treatment of APN in Korea during 2010–2014.

Differences in antibiotic usage patterns for acute pyelonephritis according to hospital type and region in the Republic of Korea

“…The average antibiotic usage was the highest among patients admitted to tertiary hospitals (13.8 DDD), followed by patients admitted to secondary hospitals (11.5 DDD), clinics (10.0 DDD), and primary hospitals (9.8 DDD). [ 11 ]…”

“…Our previous study using National Health Insurance claims data in Korea showed that the number of prescriptions of broad-spectrum antibiotics for APN treatment increased annually between 2010 and 2014. [ 11 ] However, we were not able to obtain enough evidence to determine the main reason for such phenomenon.…”

“…We aimed to determine the antibiotic prescribing practices for the treatment of APN according to hospital type and region. To achieve this goal, we reanalyzed our previous data, which focused on the annual change in antibiotic usage patterns for the treatment of APN, [ 11 ] from a different viewpoint.…”

Changes in Clinical Characteristics of Community-Acquired Acute Pyelonephritis and Antimicrobial Resistance of Uropathogenic Escherichia coli in South Korea in the Past Decade

“…As time goes by, the characteristics of disease change. According to recent studies about APN in South Korea using the claim database from 2010 to 2014, the annual incidence rate was on the increase year upon year and prescription of broad-spectrum antibiotics for the treatment of APN had increased [ 10 , 11 ]. In the present study, we identified the change in characteristics of CA-APN in South Korea from the clinical aspect.…”

“…Furthermore, entry barriers to the hospitals have decreased due to the improvement of the social welfare system and the rapid expansion of private medical insurance in the last decade [ 10 ]. Accordingly, we could find that the epidemiologic characteristics of APN, such as the incidence and medical cost, as well as antibiotic prescription patterns for the treatment of APN, have changed in South Korea [ 10 , 11 ].…”