Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
Department of Internal Medicine, Eulji University School of Medicine, Daejeon, Korea.
Korean J Intern Med. 2020 May;35(3):703-713. doi: 10.3904/kjim.2017.332. Epub 2018 Sep 27.
BACKGROUND/AIMS: This study was performed to evaluate trends in antibiotic usage at a tertiary care hospital in Korea.
This study collated antibiotic prescription data and total patient days for inpatients at a tertiary care hospital in Korea between 2004 and 2013. The consumption of each class of antibiotic was converted to defined daily dose (DDD)/1,000 patient-days. We defined 3rd generation cephalosporins, 4th generation cephalosporins, β-lactam/β-lactamase inhibitors, and fluoroquinolones as broad-spectrum antibiotics; carbapenems, tigecycline, glycopeptides, oxazolidinone, and polymyxin were defined as antibiotics against multidrug-resistant (MDR) pathogens. Other antibiotic classes were defined as nonbroad-spectrum antibiotics.
Mean antibiotic consumption was 920.69 DDD/1,000 patient-days. The proportions of broad-spectrum antibiotics, antibiotics against MDR pathogens, and nonbroad-spectrum antibiotics were 41.8% (384.48/920.69), 3.5% (32.24/920.69), and 54.7% (503.97/920.69), respectively. Consumption of broad-spectrum antibiotics (coefficient for time 0.141; p = 0.049) and antibiotics against MDR pathogens (coefficient for time 0.185; p < 0.001) showed a significant increasing trend over the study period. Nonbroad-spectrum antibiotic consumption showed a significant decreasing trend over the study period (coefficient for time -2.601; p < 0.001).
Over the 10-year period, a stepwise increase in the consumption of broad-spectrum antibiotics and antibiotics against MDR pathogens was observed at a tertiary care hospital in Korea. Conversely, during the same period, nonbroad-spectrum antibiotic consumption showed a significant decreasing trend.
背景/目的:本研究旨在评估韩国一家三级保健医院抗生素使用趋势。
本研究收集了韩国一家三级保健医院 2004 年至 2013 年住院患者的抗生素处方数据和总患者天数。将每种抗生素的用量转换为限定日剂量(DDD)/1000 患者日。我们将第三代头孢菌素、第四代头孢菌素、β-内酰胺/β-内酰胺酶抑制剂和氟喹诺酮类定义为广谱抗生素;碳青霉烯类、替加环素、糖肽类、恶唑烷酮类和多粘菌素类定义为抗多重耐药(MDR)病原体的抗生素。其他抗生素类别被定义为非广谱抗生素。
平均抗生素用量为 920.69 DDD/1000 患者日。广谱抗生素、抗 MDR 病原体抗生素和非广谱抗生素的比例分别为 41.8%(384.48/920.69)、3.5%(32.24/920.69)和 54.7%(503.97/920.69)。广谱抗生素(时间系数 0.141;p = 0.049)和抗 MDR 病原体抗生素(时间系数 0.185;p < 0.001)的消耗呈显著增加趋势。研究期间,非广谱抗生素消耗呈显著下降趋势(时间系数-2.601;p < 0.001)。
在 10 年期间,韩国一家三级保健医院广谱抗生素和抗 MDR 病原体抗生素的使用呈逐步上升趋势。相反,在同一时期,非广谱抗生素的消耗呈显著下降趋势。