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

J Korean Med Sci. 2020 Dec 7;35(47):e390. doi: 10.3346/jkms.2020.35.e390.

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.

Keywords: Antibiotics; Korea; Pneumonia; Resistance; Stewardship.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / therapeutic use*
  • Cephalosporins / therapeutic use
  • Community-Acquired Infections / diagnosis
  • Community-Acquired Infections / drug therapy*
  • Comorbidity
  • Databases, Factual*
  • Female
  • Hospitalization
  • Humans
  • Macrolides / therapeutic use
  • Male
  • Middle Aged
  • Pneumonia / diagnosis
  • Pneumonia / drug therapy*
  • Republic of Korea

Substances

  • Anti-Bacterial Agents
  • Cephalosporins
  • Macrolides