Appropriateness of antibiotic prescriptions during hospitalization and ambulatory care: a multicentre prevalence survey in Korea
Appropriateness of antibiotic prescriptions during hospitalization and ambulatory care: a multicentre prevalence survey in Korea
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DOI：
10.1016/j.jgar.2022.03.021
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发表时间：
2022-05-08
影响因子：
4.6
通讯作者：
Kim, Hong Bin
中科院分区：
文献类型：
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作者：
Park, Se Yoon;Moon, Song Mi;Kim, Hong Bin
抗菌素耐药性是全球最紧迫的健康威胁之一。在国家一级对抗生素使用进行定性评价的需求正在增加。为了确定需要改进的领域，我们的目的是评估住院和门诊护理期间抗生素处方的流行率和适当性在韩国。方法：2018年8月29日，对韩国20家医院抗生素处方的流行率和适当性进行了评估。传染病专家确定适当性。除了抗病毒和抗结核药物，所有的抗菌药物或抗真菌药物处方在住院或门诊护理evaluated.Results：抗生素处方的患病率为14.1%（8400/59216例）的研究日期。50.8%（6557/12902）的住院患者使用抗生素，27.4%（1798/6557）的患者使用两种或两种以上抗生素。共纳入处方10948张（治疗用药7999张，手术用药2105张，内科用药844张），其中27.7%的处方不适当。手术预防最常被不适当地处方（54.4%），其次是药物预防（29.5%）和治疗性抗生素（20.5%）。最常见的治疗性抗生素适应症为呼吸道感染（29.1%，n = 2332）、胃肠道感染（22.4%，n = 1791）和尿路感染（13.1%，n = 1050）。最常见的处方抗生素是头孢菌素类（52.0%，n = 5490），其次是β-内酰胺/β-内酰胺酶抑制剂（13.7%，n = 1373），氟喹诺酮类（9.1%，n = 957），甲硝唑（6.6%，n = 699.Conclusion：这是第一次在韩国全国范围内定性抗生素处方充分性评价。很大一部分抗生素处方是不适当的。因此，需要对高频感染和处方抗生素进行干预。(c)2022作者。由Elsevier Ltd代表国际抗微生物化疗学会发表。这是一篇基于CC BY-NC-ND许可证的开放获取文章（http://creativecommons.org/licenses/by-nc-nd/4.0/）
Objectives: Antimicrobial resistance is one of the most urgent global health threats. The need for the qualitative evaluation of antibiotic use at the national level is increasing. To identify areas for improvement, we aimed to assess the prevalence and appropriateness of antibiotic prescriptions during hospitalization and ambulatory care in Korea.Methods: The prevalence and appropriateness of antibiotic prescriptions on 29 August 2018 were assessed for 20 hospitals in Korea. Infectious disease specialists determined appropriateness. Except for antiviral and anti-tuberculosis agents, all antibacterial or antifungal agent prescriptions during hospitalization or ambulatory care were evaluated.Results: The prevalence of antibiotic prescription was 14.1% (8,400/59 216 patients) on the study date. Antibiotics were prescribed for 50.8% of inpatients (6557/12 902), with two or more antibiotics prescribed for 27.4% (1798/6557) of patients. A total of 10 948 prescriptions (7999 therapeutic, 2105 surgical prophylaxes, and 844 medical prophylaxes) were included in the final analysis, and 27.7% of these were inappropriate. Surgical prophylaxis was inadequately prescribed most frequently (54.4%), followed by medical prophylaxis (29.5%) and therapeutic antibiotics (20.5%). The most common indications for therapeutic antibiotics were respiratory (29.1%, n = 2332), gastrointestinal (22.4%, n = 1791), and urinary tract infec-tions (13.1%, n = 1050). The most frequently prescribed antibiotics were cephalosporins (52.0%, n = 5490), followed by beta lactam/beta lactamase inhibitors (13.7%, n = 1373), fluoroquinolones (9.1%, n = 957), and metronidazole (6.6%, n = 699).Conclusion: This was the first nationwide qualitative antibiotic prescription adequacy evaluation in Korea. A significant proportion of antibiotic prescriptions were inappropriate. Therefore, interventions for high-frequency infections and prescription antibiotics are needed.(c) 2022 The Author(s). Published by Elsevier Ltd on behalf of International Society for Antimicrobial Chemotherapy. This is an open access article under the CC BY-NC-ND license ( http://creativecommons.org/licenses/by-nc-nd/4.0/ )