Song Yun-Kyoung, Han Nayoung, Kim Myeong Gyu, Chang Hyeu-Jin, Sohn Hyun Soon, Ji Eunhee, Oh Jung Mi
College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, Republic of Korea.
College of Pharmacy, CHA University, Gyeonggi-do, Republic of Korea.
Arch Dis Child. 2017 Jul;102(7):660-666. doi: 10.1136/archdischild-2016-310981. Epub 2017 Jan 24.
Information on the use of antibiotics in Eastern Asian children is limited. The objectives of this study were to evaluate in Korean paediatric outpatients (1) the nationwide pattern of prescribing antibiotics according to age group and medical institution and (2) the adherence of antibiotic use for acute respiratory tract infections to both national guidelines and European antibiotic prescribing quality indicators.
This population-based study used the national insurance reimbursement database for 2011. The study subjects were outpatients younger than 18 years old prescribed systemic antibiotics. Patterns of antibiotic prescription were compared according to diagnostic conditions, age group and medical institution. The disease-specific proportion of recommended antibiotic or quinolone use for acute respiratory tract infections was evaluated on the basis of clinical practice guidelines and European quality indicators.
The data consisted of 70.7 million prescription records for 7.9 million paediatric outpatients, which means that 79.3% of the whole paediatric population used antibiotics. Broad-spectrum antibiotics made up 78.5% of the prescriptions, with broad-spectrum penicillins such as amoxicillin/clavulanate being the most commonly prescribed (50.2%). They were prescribed more commonly in younger paediatric patients (∼80%) than in adolescents (66.6%). The leading diagnosis accounting for antibiotic prescription was bronchitis (35.9%). The prescription proportion of recommended antibiotics in the European quality indicators was extremely low compared with the national guidelines: <0.1% for pharyngotonsillitis and 13.4% for acute otitis media.
Antibiotic use in children in Korea is inappropriately high. In addition, broad-spectrum antibiotics are used excessively.
关于东亚儿童使用抗生素的信息有限。本研究的目的是评估韩国儿科门诊患者中：（1）根据年龄组和医疗机构划分的全国抗生素处方模式；（2）急性呼吸道感染抗生素使用对国家指南和欧洲抗生素处方质量指标的依从性。
这项基于人群的研究使用了2011年的国家保险报销数据库。研究对象为年龄小于18岁且开具了全身用抗生素的门诊患者。根据诊断情况、年龄组和医疗机构比较抗生素处方模式。根据临床实践指南和欧洲质量指标评估急性呼吸道感染推荐使用抗生素或喹诺酮的疾病特异性比例。
数据包括790万儿科门诊患者的7070万条处方记录，这意味着79.3%的儿科患者使用了抗生素。广谱抗生素占处方的78.5%，其中阿莫西林/克拉维酸等广谱青霉素是最常用的（50.2%）。它们在年幼儿科患者（约80%）中的处方频率高于青少年（66.6%）。导致抗生素处方的主要诊断是支气管炎（35.9%）。与国家指南相比，欧洲质量指标中推荐抗生素的处方比例极低：咽炎和扁桃体炎低于0.1%，急性中耳炎为13.4%。
韩国儿童抗生素使用不当过高。此外，广谱抗生素使用过度。
