• YAKHAK HOEJI
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• v.57 no.3
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• pp.199-204
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• 2013

This study aimed to quantify antibiotic consumption and expenditures for acute upper respiratory tract infections (URIs) (J00-J06) in outpatients from 2009 to 2011. We used WHO ATC classification and DDDs in measuring antibiotic consumption. National Health Insurance and Medical Aid claims data were analyzed. Antibiotic consumption has decreased from 4.44 DDD/1,000inhabitants/day in 2009, to 4.43 in 2010 and 3.74 in 2011. The estimated expenditures were 8,206 won/1,000inhabitants/day in 2009, 8,379 in 2010, and 7,004 in 2011. Clinics accounted for 89.8% and 86.0% of antibiotic consumption and expenditures respectively for the acute URIs in 2011. We need to monitor antibiotic consumption consistently, and promote judicious antibiotic use.

• YAKHAK HOEJI
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• v.58 no.3
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• pp.200-207
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• 2014

This study aimed to assess the quality of outpatient antibiotic consumption in Korea compared with other countries. We used the National Health Insurance claims data for outpatient services in March, June, September, and December in 2012 and calculated nine indicator values based on the 12 European Surveillance of Antimicrobial Consumption (ESAC) drug-specific quality indicators. Indicator values in this study reflect the yearly use of antibiotic expressed in defined daily doses for 1,000 inhabitants per day (DID) and the use of main subclasses of antibiotics expressed in DID and as percentage of the total antibiotic use. Korea showed lower quality in the consumption of total antibiotics (J01), especially in the use of Cephalosporins (J01D) expressed in DID. Korea also showed low quality with regard to the use of narrow/broad spectrum antibiotics. The percentage of the use of narrow-spectrum Penicillins (J01CE) was lowest in Korea. The quality on the use of the third- and fourth-generation cephalosporin (J01(DD+DE)) was the fourth lowest among 26 countries. High rates of antibiotic resistance and payment system based on fee-for-service might have influenced on the high consumption of the broad spectrum antibiotics in Korea. It needs to further investigate the use of broad-spectrum antibiotics to identify the target of strategies promoting quality use of antibiotics in Korea.

• Pediatric Infection and Vaccine
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• v.22 no.3
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• pp.178-185
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• 2015

Purpose: We investigated trends in antibiotic pressure and the antibiotic susceptibility of gram negative bacteria isolated from Korean children over 10 consecutive years. Methods: From January 2004 to December 2013, the antibiotic susceptibility of Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa, and Acinetobacter baumannii blood isolates obtained from children <18 years of age was determined according to the 2009 Clinical and Laboratory Standards Institute guidelines. Antibiotic consumption data were also analyzed. Results: The prevalence of K. pneumoniae, E. coli, P. aeruginosa, and A. baumannii bacteremia was 4.6, 3.5, 3.4, and 2.2 cases/1,000 blood cultures/year, respectively. In K. pneumoniae, resistance to the third and fourth cephalosporin did not increase significantly. However, carbapenem-resistant K. pneumoniae first appeared in 2010, and the resistance rate increased to 9% between 2012 and 2013. Resistance to 3rd and 4th cephalosporin increased from 10% to 50% in E. coli, and resistance to carbapenem rose abruptly from 11% to 71% in A. baumannii (P for trend <0.01). However, such an increase of resistance was not observed in P. aeruginosa. There is a positive correlation between the resistance rate of cefepime in E. coli and the consumption of cefepime (r=0.900, P=0.037). Conclusion: The significant burden of antibiotic consumption and the high prevalence of antibiotic resistance to gram negative pathogen isolated from bacteremic children were observed. Empirical antibiotics should be wisely selected, and continued efforts to decrease the overall antibiotic pressure are mandatory, especially in highly resistant situations.

• Clinical and Experimental Pediatrics
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• v.62 no.4
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• pp.113-118
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• 2019

Inappropriate antibiotic use is the most important factor causing increased bacterial resistance to antibiotics, thus affecting patient outcomes. Multidrug-resistant bacteria have become a serious public health threat, causing significant morbidity and mortality worldwide. In Korea, the burden of antibiotic-resistant bacteria has become an important public health issue. There is increasing evidence of overuse and misuse of antibiotics in Korea, as observed in cohorts with large sample sizes. Antibiotic use among children should receive particular attention because of the frequency of community-associated infections among this population and the elevated risk of transmission. Recent studies from Korea have demonstrated that the use of broad-spectrum antibiotics, either for inpatient or outpatient treatment, has increased among many age groups, especially children. In this review, we aim to describe the patterns of antibiotic prescription and evaluate recent trends in antibiotic use among children. Coordinated efforts toward communication and education in order to address misunderstandings regarding antibiotic use, involving interprofessional antimicrobial stewardship programs, are required in the near future.

• Microbiology and Biotechnology Letters
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• v.49 no.1
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• pp.39-44
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• 2021

As consumption of healthy foods continues to garner remarkable public attention, ensuring probiotic safety has become a priority. In this study, the safety of Lactobacillus acidophilus IDCC 3302 was assessed in vitro and in vivo. L. acidophilus IDCC 3302 showed negative results for hemolytic and β-glucuronidase activities. The whole-genome analysis (WGA) revealed that L. acidophilus IDCC 3302 did not possess antibiotic resistance or virulence genes. The minimal inhibitory concentrations of L. acidophilus IDCC 3302 confirmed its safety concerning antibiotic resistance. Furthermore, L. acidophilus IDCC 3302 was demonstrated to be nontoxic in the oral toxicity test in rats. Therefore, the results suggested that L. acidophilus IDCC 3302 might be safe for human consumption.

• Journal of Environmental Health Sciences
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• v.38 no.2
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• pp.142-150
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• 2012

Objectives: To estimate the multi-antibiotic resistant bacterial contaminant load discharged from livestock farms, we randomly selected livestock farms specializing in cattle, swine, and fowl and collected bacterial strains from domesticated animal feces and compost samples. Problems with resistance to antibiotics are becoming worldwide issues, and as the consumption of antibiotics appears to be excessive in Korea as well, the emergence of antibiotic resistant bacteria shows the possibility to cause potentially serious social problems. Methods: To monitor multi-antibiotic resistant bacterial constituents, aerobic bacteria and Escherichia coli were isolated from domesticated animal feces and compost. Antibiotic resistance testing was performed by the disc diffusion method using 13 different antibiotics. Results: Examining the degree of sensitivity to antibiotics of the aerobic bacteria originating from domesticated animal feces, fowl feces showed the highest distribution rate (35.5%), followed by swine feces compost (23.1%), swine feces (18.2%), cattle feces (14.9%), and cattle feces compost (8.2%). Antibiotic resistance tests of aerobic bacteria and E. coli originating from domestic animals feces resulted in 83.6% and 73.5% of each strain showing resistance to more than one antibiotic, respectively. Conclusions: These results suggest that increasing multi-antibiotic resistant bacteria in the environment has a close relation to the reckless use of antibiotics in livestock.

• Journal of Environmental Health Sciences
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• v.40 no.3
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• pp.225-233
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• 2014

Objective: This study was performed in order to investigate the distribution of antibiotic resistant E. coli and water quality in waterscape facilities. Methods: Nine waterscape facilities were selected and classified into three types: ground, wall and general fountain. The items analyzed in this study were pH, turbidity, $KMnO_4$ consumption, total colony, total coliforms, fecal coliforms and E. coli. Additionally, an antibiotic resistance test on E. coli was performed. Results: There were no sampling sites that exceeded the permitted limits of water quality, but the concentration of pollutants was high at the beginning operation in June. Moreover, concentration of turbidity, $KMnO_4$ consumption and total colony were higher in ground fountains than in wall and general fountains. Five species of antibiotic resistant E. coli were detected from three sampling sites. Conclusions: The waterscape facilities were significantly contaminated with water microorganisms, especially total colony, total coliforms and fecal coliforms. Disinfection and filtration systems to remove pollutants should be installed for safe waterscape facilities.

• Asian-Australasian Journal of Animal Sciences
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• v.29 no.9
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• pp.1300-1308
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• 2016

This study was conducted to evaluate the effects of phytogenic additive and antibiotic growth promoter in laying Japanese quails. One hundred and sixty five quails were divided into three groups of 5 replicates and 11 quails (8 females and 3 males) in each replicate. Treatment 1 was fed control diet, treatment 2 was fed control diet supplemented with 0.05% bacitracin methylene disalicylate as antibiotic growth promoter and treatment 3 was fed control diet supplemented with 0.1% phytogenic feed additive (PFA) for two periods of 3 weeks each from 37 to 42 weeks of age. Results showed that egg production, eggshell strength, eggshell weight, villus height and villus height to crypt depth ratio were significantly (p${\leq}$0.05) increased and feed consumption, feed conversion ratio, albumen, Haugh unit, cholesterol, low-density lipoprotein, alanine transaminase, gamma glutamyltransferase, alkaline phosphatase, high-density lipoprotein, triglyceride, number of goblet cell, crypt depth and intestinal bacterial population of Coliforms, Salmonella and E. coli were significantly (p${\leq}$0.05) decreased in PFA fed group. It is concluded that addition of PFA containing phytomolecules and organic acids as main ingredients could significantly improve the production parameters and the general health of laying quails as an alternative to antibiotic growth promoters.

• Korean Journal of Soil Science and Fertilizer
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• v.40 no.1
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• pp.43-50
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• 2007

Veterinary antibiotics have been widely used to increase feed efficiency, to prevent disease, and to promote growth as well as to control disease. The antibiotics administered can be excreted through the urine and feces. One of the major routes of veterinary antibiotics entering soil and water environment is via the application of animal manure to agricultural land as an organic fertilizer source. Since little is known about impacts of antibiotics on the environment, this study was conducted to prioritize the veterinary antibiotics based on the consumption and potential to reach the environment. Among 83 veterinary antibiotics consumed in Korea, ten antibiotics were used at the greater dose than 25 Mg in 2004. Potential to reach the environment was determined according to excretion rate after administered to animals and sorption affinity to soil solids after applied to agricultural land. Seventeen antibiotic active ingredients (Ais) were classified as 'High' priority in terms of the potential to reach the environment. An overall priority score was determined by combining priority score based on consumption with the degree of potential environment exposure. Twenty veterinary antibiotic AIs were classified as 'Very high' or 'High' priority requiring detailed assessment. The antibiotic AIs were identified four aminoglycosides, two macrolides, two penicillins, five sulfonamides, three tetracyclines, two quinolones, and two miscellaneous. Eight veterinary antibiotic AIs including amoxicillin, carbadox, chlortetracycline, neomycin, oxytetracycline, sulfamethazine, sulfathiazole, and tylosin were identified to have a greater priority of environmental risk in Korea.

• The Korean journal of internal medicine
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• v.39 no.3
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• pp.399-412
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• 2024

Antimicrobial stewardship programs (ASPs) can lower antibiotic use, decrease medical expenses, prevent the emergence of resistant bacteria, and enhance treatment for infectious diseases. This study summarizes the stepwise implementation and effects of ASPs in a single university-affiliated tertiary care hospital in Korea; it also presents future directions and challenges in resource-limited settings. At the study hospital, the core elements of the ASP such as leadership commitment, accountability, and operating system were established in 2000, then strengthened by the formation of the Antimicrobial Stewardship (AMS) Team in 2018. The actions of ASPs entail key components including a computerized restrictive antibiotic prescription system, prospective audit, post-prescription review through quantitative and qualitative intervention, and pharmacy-based interventions to optimize antibiotic usage. The AMS Team regularly tracked antibiotic use, the effects of interventions, and the resistance patterns of pathogens in the hospital. The reporting system was enhanced and standardized by participation in the Korea National Antimicrobial Use Analysis System, and educational efforts are ongoing. Stepwise implementation of the ASP and the efforts of the AMS Team have led to a substantial reduction in the overall consumption of antibiotics, particularly regarding injectables, and optimization of antibiotic use. Our experience highlights the importance of leadership, accountability, institution-specific interventions, and the AMS Team.