A national pharmacoepidemiological study of antibiotic use in Korean paediatric outpatients
Yun-Kyoung Song1, Nayoung Han1, Myeong Gyu Kim1
1College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, Republic of Korea.
Insights
Antibiotic use in Korean children is excessively high, with broad-spectrum antibiotics frequently prescribed. Adherence to guidelines for acute respiratory infections is notably low.
Area of Science:
- Pediatric Infectious Diseases
- Antimicrobial Stewardship
- Public Health Policy
Background:
- Limited data exists on antibiotic prescribing patterns in Eastern Asian pediatric populations.
- This study addresses the knowledge gap by examining antibiotic use in Korean children.
Purpose of the Study:
- To analyze nationwide antibiotic prescribing trends in Korean pediatric outpatients by age and institution.
- To assess adherence to national guidelines and European quality indicators for antibiotic use in acute respiratory tract infections.
Main Methods:
- Utilized the 2011 Korean national insurance reimbursement database for pediatric outpatients (<18 years).
- Compared antibiotic prescription patterns across diagnoses, age groups, and medical institutions.
- Evaluated disease-specific recommended antibiotic/quinolone use against clinical guidelines and European quality indicators.
Main Results:
- 79.3% of 7.9 million pediatric outpatients received antibiotics, totaling 70.7 million prescriptions.
- Broad-spectrum antibiotics constituted 78.5% of prescriptions, with amoxicillin/clavulanate most common (50.2%).
- Adherence to European quality indicators was very low (<0.1% for pharyngotonsillitis, 13.4% for acute otitis media).
Conclusions:
- Antibiotic consumption among Korean children is inappropriately high.
- There is excessive utilization of broad-spectrum antibiotics in pediatric care.
- Current prescribing practices show poor adherence to established quality indicators for common pediatric infections.
Background:
Information on the use of antibiotics in Eastern Asian children is limited. The objectives of this study were to evaluate in Korean paediatric outpatients (1) the nationwide pattern of prescribing antibiotics according to age group and medical institution and (2) the adherence of antibiotic use for acute respiratory tract infections to both national guidelines and European antibiotic prescribing quality indicators.
Method:
This population-based study used the national insurance reimbursement database for 2011. The study subjects were outpatients younger than 18 years old prescribed systemic antibiotics. Patterns of antibiotic prescription were compared according to diagnostic conditions, age group and medical institution. The disease-specific proportion of recommended antibiotic or quinolone use for acute respiratory tract infections was evaluated on the basis of clinical practice guidelines and European quality indicators.
Results:
The data consisted of 70.7 million prescription records for 7.9 million paediatric outpatients, which means that 79.3% of the whole paediatric population used antibiotics. Broad-spectrum antibiotics made up 78.5% of the prescriptions, with broad-spectrum penicillins such as amoxicillin/clavulanate being the most commonly prescribed (50.2%). They were prescribed more commonly in younger paediatric patients (∼80%) than in adolescents (66.6%). The leading diagnosis accounting for antibiotic prescription was bronchitis (35.9%). The prescription proportion of recommended antibiotics in the European quality indicators was extremely low compared with the national guidelines: <0.1% for pharyngotonsillitis and 13.4% for acute otitis media.
Conclusions:
Antibiotic use in children in Korea is inappropriately high. In addition, broad-spectrum antibiotics are used excessively.
More Related Videos
06:05Using the Overlay Assay to Qualitatively Measure Bacterial Production of and Sensitivity to Pneumococcal Bacteriocins
Published on: September 30, 2014
11:17Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
Published on: August 30, 2018
Related Concept Videos
01:26Pharmacokinetics in Pediatric Patients: Drug Excretion
01:23Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption
01:24Pharmacokinetics in Pediatric Patients: Drug Metabolism
01:17Pharmacokinetics in Pediatric Patients: Drug Distribution
01:29Drug Dosing: Infants and Children
01:01Dosage Regimens: Partial Pharmacokinetic Parameters