Artificial Intelligence Big Data Medical Center, Yonsei University Wonju College of Medicine, Wonju, Korea.
Department of Dental Hygiene, College of Bioecological Health, Shinhan University, Uijeongbu, Korea.
Int Dent J. 2021 Dec;71(6):491-499. doi: 10.1016/j.identj.2021.01.010. Epub 2021 Mar 24.
Microbial resistance due to antibiotic misuse is a worldwide problem. This study aimed to examine the trends in antibiotic prescription after tooth extraction in Korea.
From the database of National Health Insurance Sharing Service, patients who underwent tooth extraction from 2002 to 2018 were selected as subjects, and 10% of them were selected via stratified sampling based on sex and age. Overall, 15,838,529 cases were observed for annual antibiotic prescription and broad-spectrum antibiotic prescription patterns. Additionally, standardized annual antibiotic use was calculated using a defined daily dose.
Prescriptions were issued in 13,429,770 (84.8%) of the tooth extraction cases, of which 12,179,185 (90.7%) included antibiotics. Logistic regression analysis revealed that the likelihood of prescribing antibiotics after tooth extraction decreased in 2003 compared to 2002 (odds ratio, 0.95) but increased from 2004 to 2018. In the case of the broad-spectrum antibiotic prescription rate, there was no clear trend between 2002 and 2012 (odds ratio, 0.89-1.07); however, over the last 5 years, the likelihood of broad-spectrum antibiotic prescription has steadily increased. The value of antibiotics based on the defined daily dose of 1000 patients per day was calculated to be 4.39 in 2002, exhibiting a steady increase later and reaching 6.97 in 2018, whereas that of broad-spectrum antibiotics was 1.68 in 2002 and has since been on the rise; the highest was 3.82 in 2018.
Antibiotic use after tooth extraction increased over the last 17 years; additionally, the rate of prescribing broad-spectrum antibiotics has increased over the last 5 years.
抗生素滥用导致的微生物耐药性是一个全球性问题。本研究旨在考察韩国拔牙后抗生素处方的趋势。
从国家健康保险协同服务数据库中选择 2002 年至 2018 年接受拔牙的患者作为研究对象，根据性别和年龄进行分层抽样，抽取其中的 10%作为样本。共观察到 15838529 例拔牙患者的年度抗生素处方和广谱抗生素处方模式。此外，使用限定日剂量计算标准化的年度抗生素使用量。
在 13429770 例（84.8%）拔牙病例中开具了处方，其中 12179185 例（90.7%）包含抗生素。逻辑回归分析显示，与 2002 年相比，2003 年拔牙后开具抗生素处方的可能性降低（优势比，0.95），但从 2004 年到 2018 年有所增加。在广谱抗生素处方率方面，2002 年至 2012 年之间没有明显趋势（优势比，0.89-1.07）；然而，在过去 5 年中，广谱抗生素处方的可能性稳步增加。以 1000 名患者/天的限定日剂量为基础计算的抗生素价值在 2002 年为 4.39，随后稳步上升，2018 年达到 6.97，而广谱抗生素的价值在 2002 年为 1.68，此后一直在上升；最高值为 2018 年的 3.82。
拔牙后抗生素的使用在过去 17 年中有所增加；此外，过去 5 年广谱抗生素的处方率有所上升。
