• YAKHAK HOEJI
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• v.55 no.6
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• pp.492-499
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• 2011

The objective of this study is to examine the association between the knowledge and behavior of consumers on antibiotics use for common cold. Consumers' knowledge about antibiotics was measured by a questionnaire consisting of six items related to the effect of antibiotics and another three items about use of antibiotics. Telephone interview was conducted during the days between June 24 and July 2, 2009, and 1,015 persons responded the interview. Final analysis included 896 persons without missing data. Thirty six percent of respondents answered that they checked their prescriptions to ensure that antibiotics was prescribed for common cold. About 6% asked their doctors to prescribe antibiotics for common cold, and 9.7% asked them not to. More than a quarter of respondents answered that they used to take antibiotics leftover from a previous illness. Patients who knew better about the effect of antibiotics on common cold were more likely to ask doctors not to prescribe antibiotics (OR 2.30, 95% CI 1.45~3.65), or to check prescriptions (OR 1.86, 95% CI 1.40~2.46). Higher knowledge about use of antibiotics was related to low probability of asking doctors to prescribe antibiotics. This result suggests that consumers' knowledge about antibiotics can influence doctor's prescription of antibiotics for common cold.

• YAKHAK HOEJI
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• v.58 no.3
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• pp.200-207
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• 2014

This study aimed to assess the quality of outpatient antibiotic consumption in Korea compared with other countries. We used the National Health Insurance claims data for outpatient services in March, June, September, and December in 2012 and calculated nine indicator values based on the 12 European Surveillance of Antimicrobial Consumption (ESAC) drug-specific quality indicators. Indicator values in this study reflect the yearly use of antibiotic expressed in defined daily doses for 1,000 inhabitants per day (DID) and the use of main subclasses of antibiotics expressed in DID and as percentage of the total antibiotic use. Korea showed lower quality in the consumption of total antibiotics (J01), especially in the use of Cephalosporins (J01D) expressed in DID. Korea also showed low quality with regard to the use of narrow/broad spectrum antibiotics. The percentage of the use of narrow-spectrum Penicillins (J01CE) was lowest in Korea. The quality on the use of the third- and fourth-generation cephalosporin (J01(DD+DE)) was the fourth lowest among 26 countries. High rates of antibiotic resistance and payment system based on fee-for-service might have influenced on the high consumption of the broad spectrum antibiotics in Korea. It needs to further investigate the use of broad-spectrum antibiotics to identify the target of strategies promoting quality use of antibiotics in Korea.

• Quality Improvement in Health Care
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• v.5 no.1
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• pp.58-75
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• 1998

Background : In Korea, the rational use of antibiotics are rarely controlled, and their patterns of utilization are not understood. In order to reduce the excessive use and to improve the appropriate use of antibiotics, it is necessary to accurately determine present uses of antibiotics in hospitals. Methods : Analysis of the use of prescription drugs was performed on NFMI(National Federation of Medical Insurance) 1994 medical expense claim data. A stratified sampling by types of hospitals, departments, and diseases was obtained from 1994 August data. Patients with secondary diseases were excluded. In this study, 2,697 adults with URI, 6,397 children with URI, 704 adults with bronchitis, and 1,838 children with bronchitis were included. Results : Most patients were prescribed medication (95.2-99.6%). Of the patients prescribed medication, more than 85% of URI patients and more than 91% of bronchitis patients were prescribed antibiotics. Antibiotics expenses accounted for 14% of total medical expenses in adults and 9% of total medical expenses in children. In adults with URI, antibiotics expenses accounted for 52% of drug expenses. Of the patients prescribed antibiotics, average number of antibiotics used was 1.6-1.7. For patients who are prescribed antibiotics, drug expenses were 62-97% greater than patients not prescribed antibiotics. When children were prescribed antibiotics, the highest price of drugs prescribed were 3.4-fold greater. In addition, the number of drugs prescribed also increased by more than one. Elderly patients, more than 60 years, were prescribed antibiotics less frequently. Children less than 10 years and elderly patients greater than 60 years old were prescribed fewer antibiotics than other patients. And they were prescribed medications for longer days than other patients. Conclusion : This study demonstrated that the average rate of prescribing antibiotics was higher in Korea than other countries. Measures to reduce overuse of antibiotics and to improve the appropriate prescription of antibiotics must be considered for cost effective treatment and overall health of people.

• Journal of Hospice and Palliative Care
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• v.25 no.1
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• pp.50-54
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• 2022

Antibiotics are commonly prescribed medications in the hospice and palliative care setting, as well as in many other healthcare settings. The overuse or negligent use of antibiotics is associated with the harmful consequence of fostering the development of antibiotic-resistant pathogens. Thus, there is an urgent need to critically examine and audit antibiotic use in all aspects of healthcare. In the status quo, there is a lack of consistent standards and guidelines surrounding the use of antibiotics in hospice and palliative care settings, leading to significant variations in how antibiotics are prescribed and administered in end-of-life care. It is apparent that greater thought needs to go into antibiotic decisions for patients receiving hospice or palliative care, especially considering the harmful consequences of the overprescription of antibiotics. The literature suggests that many clinicians prescribe antibiotics inappropriately for patients who would not benefit from their use or prescribe them without adequate documentation. Clinicians should be deliberate about when they prescribe antibiotics and adhere to the appropriate documentation standards and procedures within their institution or community. Future research should seek to generate generalizable knowledge about which patients will benefit most from antibiotic therapy during end-of-life care.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.26 no.1
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• pp.51-63
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• 2019

Purpose: The objective of this study was to investigate mothers' perception of antibiotic use for their children. Methods: A cross-sectional survey was conducted of a convenient sample of 210 mothers who visited the two pediatric hospitals in D city. Descriptive statistics, t-test, analysis of variance, Kruskal-Wallis test, Mann-Whitney U test, and Pearson correlation coefficients with SPSS WIN 24.0 were used to analyze the data. Results: The perception of mothers on antibiotic use for their children was relatively low (3.28/5) and showed a statistically significant difference based on the mothers' educational background (${\chi}^2=15.30$, p<.001). About 57-77% of participants discontinued or reduced the dosage of the antibiotics if their children's symptoms were relieved, and about 60% of them perceived that antibiotics treat viral infections. Mothers' adherence to specific doses of antibiotics in their children was positively correlated with their knowledge and beliefs (r=.17, p=.014) and their attitude regarding the use of antibiotics (r=.17, p=.014). Only 1.4% of the participants had educational experience regarding the correct use of antibiotics. Conclusion: Based on the results, it can be concluded that an educational program for mothers should be developed and to verify its effects in order to induce proper use of antibiotics among mothers.

• Korean Journal of Clinical Pharmacy
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• v.22 no.4
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• pp.291-303
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• 2012

As respiratory tract infections (RTI) account for about 60% of all antibiotic prescriptions in outpatient care setting, there are significant concerns about emerging resistance that are largely due to the excessive or inappropriate use of antibacterial agents for viral respiratory infections. This study was aimed to develop retrospective drug utilization review (DUR) program of antibiotics for RTIs using Delphi methods. Retrospective DUR criteria of antibiotics for RTIs were identified based on clinical practice guidelines and opinion of experts. Expert panel members were clinical doctors and pharmacists and Delphi method was applied by survey on 16 members of panels. The claim data from Korean Health Insurance Review & Assessment (HIRA) were used to examine trends in outpatient antibiotic prescription between Janunary to December of 2008. As results, Quality index for RTI was assessed for the claim type, antibiotics use of quantity, duration, number and cost. Antibiotic prescription rate for RTIs, Defined Daily Dose (DDD), and duration of antibiotics use were more recognized as significant quality index by experts' opinion. Use of first line agents suggested by guidelines was low and duration of antibiotics use was shorter compared to the recommendations. Antibiotics were over prescribed for RITs. However, dose and duration of antibiotics were under-used.

• Clinical and Experimental Pediatrics
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• v.62 no.4
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• pp.113-118
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• 2019

Inappropriate antibiotic use is the most important factor causing increased bacterial resistance to antibiotics, thus affecting patient outcomes. Multidrug-resistant bacteria have become a serious public health threat, causing significant morbidity and mortality worldwide. In Korea, the burden of antibiotic-resistant bacteria has become an important public health issue. There is increasing evidence of overuse and misuse of antibiotics in Korea, as observed in cohorts with large sample sizes. Antibiotic use among children should receive particular attention because of the frequency of community-associated infections among this population and the elevated risk of transmission. Recent studies from Korea have demonstrated that the use of broad-spectrum antibiotics, either for inpatient or outpatient treatment, has increased among many age groups, especially children. In this review, we aim to describe the patterns of antibiotic prescription and evaluate recent trends in antibiotic use among children. Coordinated efforts toward communication and education in order to address misunderstandings regarding antibiotic use, involving interprofessional antimicrobial stewardship programs, are required in the near future.

• Korean Journal of Clinical Pharmacy
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• v.23 no.1
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• pp.26-32
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• 2013

Objective: This study was to define the clinical effect on the clinical decision support system (CDSS) for prescribing antibiotics integrated with the order communication system in a National Hospital. Method: We extracted data collected before integrating the CDSS of 4,406 adult patients in 2007 and data collected after integrating the CDSS of 4,278 adult patients in 2009. These patients were 50.4% and 45.2% of all patients admitted in 2007 and 2009, respectively. The clinical effect was defined as the proportion of prescribed antibiotics, the length of antibiotics use, and the DDDs (defined daily doses) of antibiotics per 1,000 patient-days using these retrospective data. Results: There were a significant change in the proportion of patient prescribed penicillins with extended spectrum (OR=0.55, p=001), penicillins included beta-lactamase inhibitors (OR=0.75, p<.001), 3rd cephalosporin (OR=1.47, p<.001). The mean of the length of antibiotics use was decreased statistically from $6.09{\pm}5.48$ to $5.85{\pm}5.51$ days (p=.003). The DDD of glycopeptides was decreased from 24.43 DDD to 19.55 DDD per 1000 patient-days. The DDD of 3rd cephalosporins was also decreased from 15.88 to 11.65. Conclusion: Therefore, the clinical decision support system for prescribing antibiotics was effective for the clinical outcomes.

• Tuberculosis and Respiratory Diseases
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• v.83 no.1
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• pp.81-88
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• 2020

Background: Use of appropriate antibiotics for the treatment of pneumonia is integral in patients admitted to intensive care units (ICUs). Although it is recommended that empirical treatment regimens should be based on the local distribution of pathogens in patients with suspected hospital-acquired pneumonia, few studies observe patients admitted to ICUs with nursing home-acquired pneumonia (NHAP). We found factors associated with the use of inappropriate antibiotics in patients with pneumonia admitted to the ICU via the emergency room (ER). Methods: We performed a retrospective cohort study of 83 pneumonia patients with confirmed causative bacteria admitted to ICUs via ER March 2015-May 2017. We compared clinical parameters, between patients who received appropriate or inappropriate antibiotics using the Mann-Whitney U, Pearson's chi-square, and Fisher's exact tests. We investigated independent factors associated with inappropriate antibiotic use in patients using multivariate logistic regression. Results: Among 83 patients, 30 patients (36.1%) received inappropriate antibiotics. NHAP patients were more frequently treated with inappropriate antibiotics than with appropriate antibiotics (47.2% vs. 96.7%, p<0.001). Methicillin-resistant Staphylococcus aureus was more frequently isolated from individuals in the inappropriate antibiotics-treated group than in the appropriate antibiotics-treated group (7.5% vs. 70.0%, p<0.001). In multivariate analysis, NHAP was independently associated with the use of inappropriate antibiotics in patients with pneumonia admitted to the ICU via ER. Conclusion: NHAP is a risk factor associated with the use of inappropriate antibiotics in patients with pneumonia admitted to the ICU via the ER.

• Journal of Dairy Science and Biotechnology
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• v.39 no.2
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• pp.63-67
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• 2021

Antibiotics are widely used to improve productivity in the dairy industry. However, the inappropriate use of antibiotics causes the deterioration in the quality of dairy products undergoing fermentation and maturation. Hence, probiotic use is emerging as an alternative to curb the increased utilization of antibiotics. Probiotics are defined as "living microorganisms that, when administered in appropriate amounts, confer health benefits on the host." They may improve host disease resistance by regulating intestinal microflora balance and promote animal growth and development. In the dairy industry, probiotics have been studied to increase milk production by improving digestion in dairy cows, enhance the content of dairy components such as milk fat and protein, reduce the risk of mastitis in cows, and increase calf weight. Thus, the use of probiotics can improve the production and safety of dairy products. However, some probiotics are still unstable during storage and have low quality and safety issues. Therefore, to reduce the use of antibiotics in the dairy industry, probiotics should be developed and produced considering the above-mentioned problems.