Park Min Soo, Kim Ki Duk, Eun Sang Jun
Department of Family Medicine, Daejeon Sun Hospital, Daejeon, Korea.
Department of Preventive Medicine, Chungnam National University College of Medicine, Daejeon, Korea.
Korean J Fam Med. 2022 Jul;43(4):231-240. doi: 10.4082/kjfm.21.0139. Epub 2022 Jul 19.
The use of topical antibiotics (TA) for prophylactic purposes after clean dermatologic procedures (CDP) is generally not recommended, and the prescription of TA needs to be individualized in consideration of each patient's situation and underlying disease. The aim of this study was to determine the proportion of patients who underwent CDP in outpatient settings and were prescribed TA inappropriately, as well as the factors that may affect the prescription of TA.
Outpatient visits coded for CDP were selected using claims data from the Health Insurance Review and Assessment Service in 2018. Of these, patients receiving TA prescriptions were classified as having inappropriate TA use, and the proportion was estimated through technical analysis. A logistic regression analysis was used to identify factors influencing inappropriate prescriptions.
Data were analyzed using 423,651 visits, and TA was prescribed for approximately 1.9% of the visits. TA usage was higher among women (2.0%), 0-19 years of age (2.2%), medical aid (2.2%), clinic settings (2.4%), and metropolitan areas (2.0%). TA was prescribed more frequently in urology (8.6%), pediatrics (5.0%), and dermatology (4.2%) than in other specialties.
The prescription rate of TA after CDP was 1.9% using the 1.4 million patient sample from the national health insurance claims data in Korea, which is equally weighted to represent 50 million people. Although the proportion of inappropriate TA prescriptions in Korea is lower than that in other nations, it cannot be overlooked because of the large number of cases. Efforts to improve quality are required to reduce the number of inappropriate prescriptions.
一般不建议在清洁皮肤手术(CDP)后预防性使用局部抗生素(TA),TA的处方需要根据每个患者的情况和基础疾病进行个体化考虑。本研究的目的是确定在门诊接受CDP且TA处方不当的患者比例,以及可能影响TA处方的因素。
使用2018年健康保险审查和评估服务机构的理赔数据,选择编码为CDP的门诊就诊病例。其中,接受TA处方的患者被归类为TA使用不当,并通过技术分析估计该比例。采用逻辑回归分析确定影响不当处方的因素。
对423,651次就诊数据进行分析,约1.9%的就诊病例开具了TA。女性(2.0%)、0 - 19岁(2.2%)、医疗救助对象(2.2%)、诊所环境(2.4%)和大城市地区(2.0%)的TA使用率较高。泌尿外科(8.6%)、儿科(5.0%)和皮肤科(4.2%)开具TA的频率高于其他专科。
使用韩国国家健康保险理赔数据中140万患者样本(该样本经加权后代表5000万人),CDP后TA的处方率为1.9%。尽管韩国不当TA处方的比例低于其他国家,但由于病例数量庞大,这一问题不容忽视。需要努力提高质量以减少不当处方的数量。