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Trend of Antibiotic Usage for Hospitalized Community-acquired Pneumonia Cases in Korea Based on the 2010-2015 National Health Insurance Data

Authors
Kim, BongyoungMyung, RangmiLee, Myoung-jaeKim, JieunPai, Hyunjoo
Issue Date
7-12월-2020
Publisher
KOREAN ACAD MEDICAL SCIENCES
Keywords
Antibiotics; Pneumonia; Resistance; Stewardship; Korea
Citation
JOURNAL OF KOREAN MEDICAL SCIENCE, v.35, no.47
Indexed
SCIE
SCOPUS
KCI
Journal Title
JOURNAL OF KOREAN MEDICAL SCIENCE
Volume
35
Number
47
URI
https://scholar.korea.ac.kr/handle/2021.sw.korea/50839
DOI
10.3346/jkms.2020.35.e390
ISSN
1011-8934
Abstract
Background: This study is to describe the changes in prescribing practices of antibiotics to treat community-acquired pneumonia (CAP) in Korea during 2010-2015. Methods: The claim database of the Health Insurance Review and Assessment Service in Korea was used to select adult patients (>= 18 years of age) admitted between 2010 and 2015, with the International Classification of Diseases, Tenth Revision codes relevant to all-cause pneumonia for the first or second priority discharge diagnosis. The episodes with hospital-acquired or healthcare-associated pneumonia were excluded. Consumption of each antibiotic was converted to defined daily dose (DDD) per episode. The amount of antibiotic consumption was compared between patients with CAP aged < 65 years and those aged >= 65 years. Results: The average amount of antibiotic consumption per episode was 15.5 DDD, which remained stable throughout the study period (P = 0.635). Patients aged >= 65 years received more antibiotics than those aged < 65 years (15.7 vs. 15.3 DDD). Third-generation cephalosporin (4.9 DDD/episode, 31.4%) was the most commonly prescribed, followed by macrolide (2.7 DDD/episode, 17.1%) and beta-lactam/beta-lactamase inhibitor (BL/BLI) (2.1 DDD/episode, 13.6%). The consumption amount of fourth-generation cephalosporin (4th CEP) (P = 0.001), BL/BLI (P = 0.003) and carbapenem (P = 0.002) increased each year during the study period. The consumption of 4th CEP and carbapenem was doubled during 2010-2015. Conclusion: The prescription of broad-spectrum antibiotics such as 4th CEP and carbapenem to treat CAP increased in Korea during 2010-2015.
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