Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
Respirology. 2012 Jan;17(1):172-9. doi: 10.1111/j.1440-1843.2011.02077.x.
Community-acquired pneumonia (CAP) is generally considered to be a major cause of morbidity and mortality. There is much controversy regarding the optimal choice of antibiotics for patients with CAP. The aim of this study was to identify the antibiotics prescribed for adults hospitalized with CAP in Korea during a calendar year.
This population-based, descriptive epidemiological study was performed using data from nationwide health insurance claims from 1 January 2004 to 31 December 2004. The study population was adults (≥18 years old), who had been hospitalized with CAP as determined by discharge diagnosis, and who had been treated with antibiotics for ≥3 days. The exclusion criteria were tuberculosis, underlying malignancies and potential nosocomial pneumonia, based on the department providing care, or surgery reports during the admission.
Of the 5592 adults hospitalized with CAP, data for 3662 (65.5%) patients was eligible for inclusion in the analysis. This included data for 1899 (51.9%) males, and 2045 (55.8%) patients ≥65 years of age. The most frequently prescribed antimicrobial regimen was β-lactam/β-lactamase inhibitors and fluoroquinolones in combination (31.0%), followed by β-lactam/β-lactamase inhibitors plus macrolides (30.2%), monotherapy (17.0%), β-lactam/β-lactamase inhibitors plus aminoglycosides (12.9%), β-lactam/β-lactamase inhibitors plus clindamycin (4.9%), and cephalosporins plus fluoroquinolones (2.5%). Monotherapy included, in decreasing order of use, cephalosporins (6.0%), fluoroquinolones (3.5%), β-lactam/β-lactamase inhibitors (2.3%) and macrolides (2.2%).
In this study, patterns of antimicrobial prescription for patients hospitalized with CAP were assessed for the first time in Korea. There was divergence from the 2009 Korean guidelines for the treatment of CAP, reinforcing the need for assessment of physicians' adherence to the guidelines.
社区获得性肺炎(CAP)通常被认为是发病率和死亡率的主要原因。对于 CAP 患者,抗生素的最佳选择存在很多争议。本研究旨在确定韩国在一个历年中因 CAP 住院的成年人使用的抗生素。
本研究为基于人群的描述性流行病学研究,使用了 2004 年 1 月 1 日至 2004 年 12 月 31 日的全国医疗保险索赔数据。研究人群为成年人(≥18 岁),根据出院诊断住院 CAP 并接受抗生素治疗≥3 天的成年人。排除标准是根据提供护理的科室或入院期间的手术报告,结核病、潜在恶性肿瘤和潜在医院获得性肺炎。
在 5592 名因 CAP 住院的成年人中,有 3662 名(65.5%)患者的数据符合纳入分析的条件。其中包括 1899 名(51.9%)男性和 2045 名(55.8%)≥65 岁的患者。最常开的抗菌治疗方案是β-内酰胺/β-内酰胺酶抑制剂和氟喹诺酮类联合(31.0%),其次是β-内酰胺/β-内酰胺酶抑制剂加大环内酯类(30.2%)、单药治疗(17.0%)、β-内酰胺/β-内酰胺酶抑制剂加氨基糖苷类(12.9%)、β-内酰胺/β-内酰胺酶抑制剂加克林霉素(4.9%)和头孢菌素类加氟喹诺酮类(2.5%)。单药治疗包括按使用频率递减的头孢菌素(6.0%)、氟喹诺酮类(3.5%)、β-内酰胺/β-内酰胺酶抑制剂(2.3%)和大环内酯类(2.2%)。
本研究首次在韩国评估了因 CAP 住院的患者的抗菌药物处方模式。与 2009 年韩国 CAP 治疗指南存在差异,这强化了评估医生遵守指南的必要性。