• 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.

• 대한한방소아과학회지
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• 제32권2호
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• pp.64-71
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• 2018

Objectives The purpose of this study is to examine the correlation of antibiotics administration duration and antimicrobial resistance by reviewing domestic and foreign literatures. Methods We searched literatures dated up to 23 February, 2018 in PubMed and Cochrane Library using terms of "Anti-Bacterial Agents", "Carrier State", "Nasopharynx", "Drug Administration Schedule", and also searched via RISS (Research Information Service System), KISS (Koreanstudies Information Service System), DBpia (DataBase Periodical Information Academic) using terms of antibiotics, resistance, and dose. Results In comparison with shortened and standard antibiotic course, longer treatment duration is associated with greater antimicrobial resistance or non-significant difference, but we cannot find literature that shortened antibiotic course increases antimicrobial resistance on human nasopharyngeal flora. Conclusions Currently, there is no evidence that completing the standard antibiotic course reduces antimicrobial resistance. It can be a strategy for reducing antibiotic use to apply Korean medicine treatment, as well as short-course antibiotic therapy or delayed antibiotic prescription. Additional well-designed trials should be conducted in domestic and foreign settings about the appropriate duration of antibiotic therapy.

• 대한두개안면성형외과학회지
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• 제20권2호
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• pp.89-93
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• 2019

Background: Prophylactic antibiotic administration after surgery for a nasal bone fracture is performed due to concerns about infection-related complications, such as, toxic shock syndrome. To evaluate the validity and efficacy of antibiotic use, we compared the results obtained and the bacterial profiles of nasal packing materials in patients that underwent closed reduction for a nasal bone fracture with or without prophylactic antibiotic administration. Methods: Thirty consecutive patients with a nasal bone fracture, but without an open wound, that underwent closed reduction during March to August 2017 were included in the present study. Fifteen of these 30 patients were randomly assigned to a control group, members of were administered postoperative intravenous antibiotics once at the day of surgery and then oral antibiotics for 4 days. The other 15 patients were assigned to an experimental group and not administered any antibiotic postoperatively. Antibiotic ointment was not applied to nasal packing in either group. Nasal packing was removed on postoperative day 4 in all cases. Removed nasal gauze packings were culture tested and strains identified in the two groups were compared. Results: Bacterial strain types cultured from packings were similar in the experimental and control groups and no patient showed signs of clinically significant infection. Conclusion: The findings of this study suggest postoperative prophylactic antibiotic use is not clinically required after closed reduction of a nasal bone fracture. Furthermore, the non-use of postoperative antibiotics is biologically beneficial, as it reduces the occurrence of resistant strains and medical costs, and is more convenient for patients.

• 도시과학
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• 제12권2호
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• pp.7-12
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• 2023

The purpose of this study is to explore the issue of antibiotic misuse and the associated environmental problems, focusing on the antibiotic sulfamethoxazole used in animal agriculture. Antibiotic resistance is currently a global problem, exacerbated by the misuse of antibiotics in agriculture and animal husbandry. This study emphasizes the importance of investigating the potential environmental toxicity of antibiotics and discovering efficient treatment technologies. It discusses the use of advanced oxidation processes and artificial wetlands as potential approaches to mitigate the environmental impact of antibiotics, particularly sulfamethoxazole. In conclusion, the study underscores the need for research, data collection, monitoring, and effective environmental protection policies to combat antibiotic misuse and environmental pollution. It also emphasizes the significance of raising awareness and implementing proactive measures to address these issues.

• 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.

• 가정∙방문간호학회지
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• 제26권1호
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• pp.51-63
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• 2019

Purpose: The objective of this study was to investigate mothers' perception of antibiotic use for their children. Methods: A cross-sectional survey was conducted of a convenient sample of 210 mothers who visited the two pediatric hospitals in D city. Descriptive statistics, t-test, analysis of variance, Kruskal-Wallis test, Mann-Whitney U test, and Pearson correlation coefficients with SPSS WIN 24.0 were used to analyze the data. Results: The perception of mothers on antibiotic use for their children was relatively low (3.28/5) and showed a statistically significant difference based on the mothers' educational background (${\chi}^2=15.30$, p<.001). About 57-77% of participants discontinued or reduced the dosage of the antibiotics if their children's symptoms were relieved, and about 60% of them perceived that antibiotics treat viral infections. Mothers' adherence to specific doses of antibiotics in their children was positively correlated with their knowledge and beliefs (r=.17, p=.014) and their attitude regarding the use of antibiotics (r=.17, p=.014). Only 1.4% of the participants had educational experience regarding the correct use of antibiotics. Conclusion: Based on the results, it can be concluded that an educational program for mothers should be developed and to verify its effects in order to induce proper use of antibiotics among mothers.

• Tuberculosis and Respiratory Diseases
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• 제70권3호
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• pp.191-198
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• 2011

Ventilator-associated pneumonia (VAP) is the most frequent nosocomial infection in the intensive care unit (ICU), with an incidence ranging from 8% to 38%. Patients who acquire VAP have higher mortality rates and longer ICU and hospital stays. Because there are other potential causes of fever, leukocytosis, and pulmonary infiltrates, clinical diagnosis of VAP is overly sensitive. The only alternative approach to the clinical diagnosis of VAP is the Clinical Pulmonary Infection Score (CPIS). Employing quantitative cultures of respiratory secretions in the diagnosis of VAP leads to less antibiotic use and probably to lower mortality. With respect to microbiologic diagnosis, however, it is not clear that the use of invasive sampling using bronchoscopy is associated with better outcomes. Delayed administration of antibiotic therapy is associated with an increased mortality, and inadequate antibiotic therapy is also associated with higher mortality. Therefore, prompt initiation of adequate antibiotic therapy is a cornerstone of the treatment of VAP. The initial antibiotic therapy should be based on the most common organisms in each hospital and the most likely pathogens for that specific patient. When final cultures and susceptibilities are available, de-escalation to less broad spectrum antibiotics should be done. Since clinical improvement usually takes 2 to 3 days, clinical responses to the initial empirical therapy should be evaluated by day 3. A short course of antibiotic therapy appears to be equivalent to a traditional course of more than 14 days, except when treating non-fermenting gram-negative organisms. If patients receive initially adequate antibiotic therapy, efforts should be made to shorten the duration of therapy to as short as 7 days, provided that the etiologic pathogen is not a non-fermenting gram-negative organism.

• 한국미생물·생명공학회지
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• 제47권2호
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• pp.173-182
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• 2019

The use of double lumen catheters as a means of hemodialysis access is commonly accompanied with the use of gentamicin as an antibiotic lock. Other antibiotics and anticoagulants are often added to increase the efficacy of gentamicin in order to reduce catheter-related infection and to prevent biofilm formation. This review aimed to evaluate the following: 1) the use of gentamicin in eliminating catheter-related infection and reducing biofilm formation in hemodialysis catheters, 2) the efficacy of additional antibiotics in combination with gentamicin, and 3) the effect of additional anticoagulants to complement the efficacy of gentamicin as the main prophylactic antibiotic lock. We sorted through data from 242 PubMed and ScienceDirect studies, which were then short-listed to 33 studies. Next, they were grouped, extracted, and analyzed qualitatively to fulfil the objectives of this review. Consequently, the use of a gentamicin-lock solution was shown to reduce the incidence of bacteremia; however, it was not strong enough to inhibit the growth of infectious microbes and formation of biofilms. Several bacteria, such as Staphylococcus aureus, Staphylococcus epidermidis, Escherichia coli, and Klebsiella pneumoniae, have been reported as infectious agents. Combination with other antibiotics also provided no effect in reducing bacterial growth and biofilm formation in catheters. Furthermore, the additional anticoagulants (trisodium citrate and EDTA) were reported to be effective in enhancing the efficacy of gentamicin in avoiding catheter-related infection, bacterial growth, and biofilm formation; thus, the use of gentamicin can be rationalized.

• 한국임상약학회지
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• 제27권3호
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• pp.186-194
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• 2017

Objectives: A significant concern has been raised about the emerging resistance that is largely caused by the excessive or inappropriate use of antibacterial agents for viral respiratory infections. This study investigated the trend of respiratory tract infections (RTIs) and the use of antibiotics. Methods: Utilizing the national level health insurance claims data from 2005 to 2008, we examined encounter days, antibiotic use, and the prescription rate for respiratory tract infections including upper respiratory tract infections (URTIs), lower respiratory tract infections (LRTIs), and otitis media in outpatient settings. The antibiotic use was measured as defined daily dose per 1,000 patients per day (DDD/1,000 patients/day). Results: The visit for URTI increased from 141,693,465 in 2005 to 120,717,966 in 2008 and the visit for LRTI decreased from 61,778,718 to 66,930,122. For RTIs, prescription rates of antibiotics decreased from 65.2% to 58.5% for URTIs and 76.9% to 68.3% for LRTIs from 2005 to 2008. The antibiotic use decreased to 20.85 DDD/1,000 patients/day after a significant increase of 22.01 DDD/1,000 patients/day in 2006. Among antibiotics, J01CR had the highest use- 7.93 DDD/1,000 patients/day followed by J01DC of 3.71 DDD/1,000 patients/day and J01FA of 3.2 DDD/1,000 patients/day. One notable trend is that J01FA presented a continuous increase in antibiotic use from 2.3 in 2005 to 3.26 DDD/1,000 patients/day in 2008. Conclusion: The use of antibiotics had poor compliance to guidelines for RTIs. Despite decrease in the use of antibiotics, prescription rates for URTIs were still about 50% indicating that the delayed prescribing antibiotics (or wait-and-see) were not observed.

• Child Health Nursing Research
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• 제30권1호
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• pp.54-66
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• 2024

Purpose: This study investigated participation in and perceptions of antibiotic stewardship among nurses at a children's hospital. Methods: This descriptive study included 125 nurses working in the inpatient ward, intensive care unit and emergency room of a single tertiary children's hospital. The study measured 14 factors influencing antibiotic stewardship behaviors using the theoretical domains framework. Each factor was analyzed by categorizing it into components (capability, opportunity, and motivation) that have been proposed as influencing factors in the COM-B model of behavior. One-way analysis of variance and Pearson correlation coefficients were used to explore differences in antibiotic stewardship behaviors and influencing factors according to general characteristics and the correlation between antibiotic stewardship behaviors and COM-B components. Results: No statistically significant difference in antibiotic stewardship behaviors was found based on the experience of antibiotic stewardship education or the nursing department. However, significant differences were observed in the perception levels of factors related to antibiotic stewardship behaviors according to the experience of antibiotic stewardship education in skill (physical) (p=.042), knowledge (p=.027), intentions (p=.028), and social influences (p=.010). Additionally, significant differences were observed in perception levels according to the sub-components of the COM-B model, specifically physical capability (p=.042), psychological capability (p=.027), and social opportunity (p=.010). Conclusion: To expand nurses' involvement and roles in antibiotic stewardship, nurses should acknowledge the significance of appropriate antibiotic use, aiming to enhance the quality of medical care and ensure patient safety. In pursuit of this objective, tailored education aligning with the specific needs and practices of nurses is essential.