Department of Pharmacy, Seoul National University Bundang Hospital 82, Seoungnam, Republic of Korea.
Department of Pharmacy, Seoul National University Bundang Hospital 82, Seoungnam, Republic of Korea; College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, Republic of Korea.
J Hosp Infect. 2024 Nov;153:81-89. doi: 10.1016/j.jhin.2024.09.009. Epub 2024 Sep 26.
Antimicrobial stewardship programmes (ASPs) have gained prominence, with increased awareness regarding the importance of appropriate antibiotic use. However, ASP implementation for outpatient antibiotic prescription is uncommon, particularly in South Korea. This study aimed to analyse the patterns and appropriateness of outpatient antibiotic prescription at a tertiary care hospital in Korea.
This study analysed the patterns of oral antibiotic prescription between 1 June 2018 and 31 May 2023 at the outpatient department of Seoul National University Bundang Hospital. The appropriateness of prescriptions issued between 15 and 19 May 2023 was assessed. The assessment criteria included: indication for antibiotic use; antibiotic choice; duration; and dose/frequency. Pharmacists and infectious diseases specialists performed evaluations.
In total, 7,282,407 outpatient visits were recorded over the 5-year study period, and oral antibiotics were prescribed in 243,967 (3.4%) cases. The frequency of antibiotic prescription was highest in dentistry, dermatology and urology departments. The most commonly prescribed antibiotics were cephalosporins, penicillins and sulphonamides. Of the 423 prescriptions evaluated, 289 (68.3%) and 134 (31.7%) were for treatment and prophylaxis, respectively. Prescriptions were classified as inappropriate in 28.4% (82/289) and 70.9% (95/134) of treatment and prophylaxis cases, respectively. The primary reason for inappropriateness in both treatment and prophylaxis cases was inappropriate indication, accounting for 46.3% (38/82) of treatment prescriptions and 96.8% (92/95) of prophylaxis prescriptions.
Antibiotics were prescribed at 3.4% of all outpatient visits. The prescription was inappropriate in 28.4% of treatment cases and 70.9% of prophylactic cases. Proactive and expansive ASP activities by pharmacists should be considered in outpatient settings.
抗菌药物管理计划（ASPs）日益受到重视，人们越来越意识到合理使用抗生素的重要性。然而，在门诊抗生素处方方面，ASPs 的实施并不常见，特别是在韩国。本研究旨在分析韩国一家三级保健医院的门诊抗生素处方模式和适宜性。
本研究分析了 2018 年 6 月 1 日至 2023 年 5 月 31 日期间，首尔国立大学盆唐医院门诊的口服抗生素处方模式。评估了 2023 年 5 月 15 日至 19 日期间开具的处方的适宜性。评估标准包括：抗生素使用的适应证；抗生素选择；疗程；以及剂量/频率。药剂师和传染病专家进行了评估。
在 5 年的研究期间，共记录了 7282407 次门诊就诊，其中 243967 例（3.4%）开具了口服抗生素。在牙科、皮肤科和泌尿科，抗生素处方的频率最高。最常开的抗生素是头孢菌素、青霉素和磺胺类药物。在评估的 423 个处方中，289 个（68.3%）和 134 个（31.7%）分别用于治疗和预防。在治疗和预防病例中，分别有 28.4%（82/289）和 70.9%（95/134）的处方被归类为不适当。在治疗和预防病例中，不适当的主要原因都是适应证不恰当，分别占治疗处方的 46.3%（38/82）和预防处方的 96.8%（92/95）。
抗生素在所有门诊就诊中的处方率为 3.4%。治疗病例中有 28.4%的处方和预防病例中有 70.9%的处方不适当。在门诊环境中，应考虑药剂师积极和广泛地开展 ASP 活动。
