• 약학회지
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• 제57권3호
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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.

• 약학회지
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• 제58권3호
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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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• 제22권3호
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• pp.178-185
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• 2015

목적: 국내 소아 그람음성균혈증에서 항생제 내성변화 및 항생제 사용량과의 관계를 분석하였다. 방법: 최근 10년간 18세 이하 입원 환자의 혈액에서 분리된 그람음성균의 항생제 내성률 변화 및 항생제 사용량과의 관계를 분석하였다. 결과: 폐렴막대균, 대장균, 녹농균, 아시네토박터 바우마니의 분리율은 연간 혈액배양 1,000건당 각각 4.6례, 3.5례, 3.4례 및 2.2례였다. 폐렴막대균에서 광범위 세팔로스포린에 대한 내성변화는 없었으나 2010년부터 카바페넴 내성 폐렴막대균이 동정된 후 점차 빈도가 증가하였다. 대장균의 광범위 세팔로스포린 내성이 10%에서 50%로 아시네토박터 바우마니의 카바페넴 내성이 11%에서 71%로 크게 증가하였다(P for trend <0.01). 녹농균은 여러 항생제에 높은 내성을 보였으나 유의한 내성변화를 보이지 않았다. 대장균의 cefepime 내성과 cefepime 사용량 사이에 유의한 양의 상관관계를 보였다(r=0.900, P=0.037). 결론: 국내 소아에서 발생한 그람음성균 균혈증 분석시 카바페넴 및 광범위 세팔로스포린 내성이 증가하였고 일부에서 항생제 사용량과의 관련성을 확인하였다. 이는 원내 경험적 항생제 결정시 중요한 고려 사항이며 추후에도 지속적인 원내 항생제 사용량 및 내성률에 대한 감시가 필요하겠다.

• Clinical and Experimental Pediatrics
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• 제62권4호
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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.

• 한국미생물·생명공학회지
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• 제49권1호
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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.

• 한국환경보건학회지
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• 제38권2호
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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.

• 한국환경보건학회지
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• 제40권3호
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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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• 제29권9호
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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.

• 한국토양비료학회지
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• 제40권1호
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• pp.43-50
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• 2007

가축 질병의 예방 및 치료뿐만 아니라 사료 이용효율 증대와 생장 촉진을 위하여 축산용 항생제가 쓰여져 왔으며, 이 항생제는 가축분뇨를 통해 배출되어 농경지에 유입될 가능성이 있다. 나아가 용탈과 표면 유거를 거쳐 수계에 도달할 수 있으나, 모든 항생제의 환경 유출 가능성을 검토하는 데에는 많은 시간과 노동력, 예산이 필요하다. 본 연구는 축산용 항생제의 사용량과 잠재적 환경 유출 가능성을 기준으로 우선 순위를 결정하고자 수행되었다. 2004년에 우리 나라에서 판매된 항생제는 83종으로 약 1,400 톤에 달하였으며, 이 가운데 25 톤 이상 사용된 항생제는 10종이었다. 3 톤 이상 쓰인 36 종의 항생제를 대상으로, 가축의 배출율과 토양 흡착 정도를 가지고 잠재적 환경 유출 가능성을 판단하여 17 종을 선발하였다. 축산용 항생제의 사용량과 잠재적 환경 유출 가능성을 종합하여 검토한 결과, amoxicillin과 carbadox, chlortetracycline, neomycin, oxytetracycline, sulfamethazine, sulfathiazole, tylosin 등 8종이 상대적으로 환경으로의 유출 가능성이 높아 금후 정밀한 평가가 요구되었다. 비록 항생제의 가축분뇨로의 배출율과 토양내 동태에 대한 정보가 제한적일지라도, 본 연구에서는 한국에서 쓰이고 있는 축산용 항생제의 사용량과 알려진 항생제의 배출율과 토양 흡착 정도를 바탕으로 환경으로의 유출 가능성이 큰 항생제를 결정하였다.

• The Korean journal of internal medicine
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• 제39권3호
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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.