Increased use of third-generation cephalosporin antibiotics in the outpatient setting in Korean children and adolescents

Pediatr Int. 2018 Sep;60(9):803-810. doi: 10.1111/ped.13651.

Abstract

Background: Antimicrobial resistance is a concern to public health, and controlling antibiotic use is therefore important. This study analyzed the trend in outpatient antibiotic prescriptions in children and adolescents in Korea.

Methods: Using National Prescribing Sample data from the Korea Health Insurance Review and Assessment Service between 1 January 2010 and 31 December 2014, we analyzed outpatient systemic antibiotic (anatomical therapeutic chemical [ATC] J01) prescriptions in patients aged 2-17 years. The antibiotic rate was defined as the proportion of all outpatient prescriptions for antibiotics. We calculated absolute and relative differences with 95%CI between 2010 and 2014 in the antibiotic rate by age group (2-6, 7-11, and 12-17 years) and the percentage of antibiotic prescriptions by antibiotic class. Seven of the most commonly used antibiotic drugs were identified based on defined daily dose.

Results: A total of 7 261 176 prescriptions were written for 1 039 756 pediatric patients between 2010 and 2014. The antibiotic rate in all patients increased from 34.8% in 2010 to 70.4% in 2014, resulting in the relative difference of 102.1% (95%CI: 101.7-102.5). Extended spectrum penicillins were the most commonly prescribed antibiotic class, accounting for 40.0-41.0% of all antibiotic prescriptions. The use of third-generation cephalosporins increased steeply with the relative difference of 55.7% (95%CI: 55.2-56.2). Amoxicillin/clavulanate, an extended spectrum antibiotic drug, was the predominately used antibiotic drug but the use of cefpodoxime, a third-generation cephalosporin, increased by 96%.

Conclusions: The use of outpatient antibiotics, especially third-generation cephalosporins, has increased in children and adolescents in Korea.

Keywords: adolescent; anti-bacterial agent; child; drug utilization; pediatrics.

MeSH terms

  • Adolescent
  • Anti-Bacterial Agents / administration & dosage*
  • Child
  • Child, Preschool
  • Drug Prescriptions / statistics & numerical data*
  • Drug Utilization / trends*
  • Female
  • Humans
  • Male
  • Outpatients / statistics & numerical data
  • Practice Patterns, Physicians' / trends*
  • Republic of Korea

Substances

  • Anti-Bacterial Agents