Antimicrobial Consumption as a Key Component of Antimicrobial Stewardship Programs: a Meaningful Movement toward Evidence-based Antimicrobial Stewardship of Validated Outcome Measures

Autor: Myoung-jae Lee, Bongyoung Kim, Rangmi Myung, Jieun Kim, Hyunjoo Pai
Rok vydání: 2020
Předmět:
Male
Carbapenem
Databases
Factual
Antibiotics
Cephalosporin
Resistance
Comorbidity
Antimicrobial Stewardship
0302 clinical medicine
Community-acquired pneumonia
Anti-Infective Agents
Outcome Assessment
Health Care
Antimicrobial stewardship
Medicine
030212 general & internal medicine
Aged
80 and over
Outcome measures
General Medicine
Middle Aged
Infectious Diseases
Microbiology & Parasitology
Antimicrobial
Anti-Bacterial Agents
Community-Acquired Infections
Hospitalization
Editorial
Female
Original Article
Macrolides
medicine.drug
medicine.medical_specialty
Evidence-based practice
medicine.drug_class
03 medical and health sciences
Internal medicine
Environmental health
Component (UML)
Republic of Korea
Humans
Stewardship
Medical prescription
Aged
Consumption (economics)
Korea
business.industry
Pneumonia
medicine.disease
Cephalosporins
Defined daily dose
National health insurance
Key (cryptography)
business
Zdroj: Journal of Korean Medical Science
ISSN: 1598-6357
Popis: 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.
Graphical Abstract
Databáze: OpenAIRE
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