• Health Policy and Management
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• 제25권4호
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• pp.256-263
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• 2015

Background: Initial treatment of acute upper respiratory infection (AURI) should not include antibiotics because most AURIs are caused by virus. However, the prescription rate of antibiotics in Korea is higher than in any other countries. Inappropriate use of antibiotics in Korea accelerated the emergence of antibiotics resistance and increased the social and economic burden. The objective of this study was to investigate the factors related to antibiotics use for the AURI among children-adolescents and adults. Methods: This study analyzed the Health Insurance Review and Assessment Service-National Patient Sample data which was nationally representative sampling stratified by sex and age. Results: The influencing factors of antibiotics use for AURI are gender, age, types of medical security, primary disease, existence of concomitant disease, treatment seasons, first visit or revisit, indicated specialty, types of medical institution, and location of medical institution. Conclusion: The results showed health policy makers are required to place more efforts to resolve inappropriate antibiotics use. Especially they need to establish a health policy to reduce the gap between areas and specialties and recommend standardized clinical guidelines according to the subgroup code of AURI and the age group of patients.

• Asian-Australasian Journal of Animal Sciences
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• 제30권12호
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• pp.1667-1673
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• 2017

Antibiotics have long been of great benefit for people, both in the medical treatment of human disease and in animal food where they improve the growth performance and feed utilization during animal production. Antibiotics as in-feed supplements affect all stages of pork production, including the gestation, nursing, growing, and finishing stages, although the effects show stage-dependent differences. However, the use of antibiotics in animal feed has become a worldwide concern. This review describes why sub-therapeutic levels of antibiotic additives in animal feed have become an integral part of animal feeding programs for more than 70 years, particularly in pork production. It also discusses the threat of the long-term use of sub-therapeutic levels of antibiotics in pork production. In recent years, the effectiveness of in-feed antibiotics has tended to decrease. This review analyzes this change from various perspectives. First, the equipment used at pig farms has improved dramatically and is more sanitary. Worldwide, more pig farms use pig farrowing crates, gestation crates, piglet nursery crates, flooring devices, piggery ventilation and cooler systems, automatic pig feeders, piggery heating equipment, and artificial insemination systems. In addition, scientists have replaced the use of antibiotics with organic acids, fermented mash, probiotics, prebiotics, minerals, oligosaccharides, enzymes, herbs/flavors, and protein/amino acids, and have improved management and husbandry techniques. In addition, animal welfare legislation has been aimed at improving the quality of the floors and living space, ensuring that animals have permanent access to fresh water, and setting a minimum weaning age. Finally, the prospects and the possibility of replacing antibiotics in pork production are described, in line with recent research results.

• Clinical and Experimental Pediatrics
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• 제51권10호
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• pp.1042-1046
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• 2008

The fluoroquinolones are an important group of antibiotics widely used in the treatment of various infectious diseases in adults, as a result of an excellent spectrum of activity, good tissue penetration and convenient ways of administration. In recent decades, there has been extensive development, clinical investigation, licensure and use of fluoroquinolone antibiotics. However, the use of fluoroquinolones in children has been limited because of their potential to induce arthropathy in juvenile animals. Despite class label warnings against use in children, prescriptions for quinolone antibiotics to treat infections in children have become increasingly prevalent. The main use of fluoroquinolones in pediatrics should be, understandably, in serious life-threatening infections for which other antibiotics therapies are not effective or available. While most of the published studies failed to detect an increased rate of articular adverse effects in children treated with fluoroquinolones, an increase in the use of these compounds, particularly in community-acquired lower respiratory infections, could accelerate the emergence of multidrug-resistant (including fluoroquinolone) pneumococcal strains. This review will discus the main issues related to the use of fluoroquinolones in children, the major problems of resistance developing among these compounds, with special emphasis on the potential side effects and skilled use of these alternative potent drugs in pediatric infection.

• Korean Journal of Clinical Pharmacy
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• 제17권1호
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• pp.19-32
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• 2007

Objectives : It is necessary to monitor consumption of drugs in order to enhance promote appropriate use of drugs. Defined Daily Dose(DDD) of World Health Organization(WHO) has been used for evaluating the amount of medicine use. However, DDD of some drugs must be determined for drugs in Korea which are not listed by WHO. Our formulary follows ourself classification and DDD of some drugs must be determined since they exist only in Korea. This study was aimed to determine DDD value using RAND Appropriateness Methods and evaluate the amount of antibiotics use using DDD value. Methods : J01 antibiotics of WHO anatomical therapeutic chemical(ATC) classification were extracted from drug formulary. Antibiotics list without DDD was identified to determine their DDD with comprehensive review of references and recommendation of experts. defined. Review of reference was executed. of Expert panels were comprised of clinical pharmacist and clinical doctors. Modified Delphi Method was applied by survey and consensus meeting. Amount of antibiotic use was calculated by DDD/1000 inhabitants/day in the national level using health insurance claim data. Results : The result of 1 round, DDD values of 28 ingredients were determined from the first round of consensus meeting. With 2nd round meeting, 3 ingredients were deleted and DDD of 17 ingredients were decided. Analysis of antibiotic use in health insurance claim data showed 22.97 DDD/1000 inhabitants/day in 2003 year. Conclusion : This study can contribute to the establishment of DDD assignment and thus quantifying drug uses.

• Korean Journal of Clinical Pharmacy
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• 제21권4호
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• pp.332-338
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• 2011

This study aimed to investigate the prescription of antibiotics in clinics, and evaluate their usage appropriateness after the 2000 Korean separation of dispensary from medical practice. A retrospective study was performed on the antibiotic use for 4 years from August 2000 to July 2004 in three clinics (general, internal medicine and ear-nose-and-throat (ENT) clinics). Moreover, prescription of antibiotics for acute upper respiratory infection (AURI), concomitant drugs, duplicate antibiotics and patient adherence were assessed for 260 patients experienced AURI in a pharmacy. The prescription rates of antibiotics amongst the whole prescription decreased annually during the study period, but those in ENT clinic still constituted more than 90%. The usage of penicillins declined, but that of broad spectrum antibiotics such as amoxicillin/clavulanic acid and 1st/2nd generation cephalosporins increased. Moreover, the categories of antibiotics for the same indication were different among the clinics. For patients with AURI, the more antibiotics were prescribed as its missing days and days under its therapeutic dose increased. The drug interactions with concomitant drugs decreased annually, but the use of duplicate antibiotics was similar across the period. Potential inappropriate antibiotic use was common after the Korean policy, so the observation of pharmacists needs in addition to the patients and practitioners' attention.

• Journal of Korean Academy of Fundamentals of Nursing
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• 제16권4호
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• pp.421-429
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• 2009

Purpose: The aim of this study was to identify knowledge and attitudes on antibiotic use held by adolescents (middle and high school students) in Korea. Methods: Data were collected from a convenience sample of 651 students residing in 5 major cities in Korea. The questionnaire was developed after an extensive literature review and professional advisory meetings. Descriptive statistics, t-test, chi square test, ANOVA, and Pearson correlation coefficients with the SPSS program were used to analyze the data. Results: Respondents correctly answered 6.23 antibiotic-related questions out of 15 questions. Two thirds of the respondents knew viruses caused most colds and coughs, but 80% did not know that antibiotics do not work against viruses. High school students' attitudes towards antibiotics were somewhat negative. More middle school students than high school students asked doctors for antibiotics for a cold. High school students did not check if antibiotics were included in their prescription for a cold. There was no significant correlation between knowledge and attitudes towards antibiotic use. Conclusion: Education programs on appropriate antibiotic use need to be developed for these students. Continual reinforcement and repetition of the contents are required to change attitudes.

• Korean Journal of Poultry Science
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• 제36권3호
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• pp.223-229
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• 2009

The objective of this study was to investigate the effect of the supplementation of antibiotics on meat quality grade of broiler carcasses under the Korean meat grading system. A total of 34,000 broiler carcasses, which were randomly selected 100 broilers from each farm in 340 broiler farms (305 farms with antibiotics; 35 farms without antibiotics), were used in this study. Average daily weight gain of broilers was not significantly affected by the use of antibiotics. The ratio of quality grade A was higher in the broiler carcasses from the farms with antibiotics supplementation (78.87%) than those without antibiotics (73.46%, P<0.05). The numbers of carcass defects, which are down-grade factors of meat grading system, were much higher in the broiler carcasses produced from the farms without antibiotics supplementation when compared with those with antibiotics. In particular, the incidence of the carcass defect on conformation was approximately 1.8 times higher in the carcasses from the farms without antibiotics supplementation than those with antibiotics, which showed the highest negative correlation with quality grade A. Therefore, the improvement of farm management system, the use of antibiotics alternatives from natural products, and a proper incentive should be considered in various ways to encourage farmers to reduce antibiotics usage in their farm and earn consumers' trust for antibiotics-free products.

• The Journal of Korean Medicine
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• 제22권3호
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• pp.179-188
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• 2001

Diarrhea is the frequent passage of loose, watery stool (frequency: ${\geq}4/day$, weight: ${\geq}250g/day$) Most antibiotics can cause inflammatory change of the colon or Pseudomembranous colitis (PMC). Typical presentations of PMC are watery diarrhea, abdominal pain, fever, leukocytosis ($12,000~20,000/\textrm{mm}^3$), hypoalbuminemia, hypovolemia and recent or concurrent use of antibiotics. Diagnostic methods of PMC are stool assay, sigmoid scopy, abdominal CT, abdominal US, etc. The age-related susceptibility noted with PMC is impressive but unexplained. Two stroke patients had diarrhea, abdominal pain, fever hypoalbuminemia and a history of recent or concurrent use of antibiotics. By use of Shirhyung- Tang, we could improve clinical symptoms (diarrhea, abdominal pain, fever hypoalbuminemia, etc.) and so report clinical course of two stroke patients with antibiotics-associated PMC.

• Clinical and Experimental Pediatrics
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• 제52권3호
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• pp.283-288
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• 2009

Pneumonia remains the leading cause of mortality in children. Diagnosis depends on a combination of factors, including clinical assessment, radiological and laboratory findings. Although Streptococcus pneumoniae remains the most important cause of childhood bacterial pneumonia, the great majority of cases of community-acquired pneumonia (CAP) are of viral etiology. A new, rapid, and inexpensive test that differentiates viral from bacterial pneumonia is needed to decide empiric antibiotic treatment. Antibiotics effective against the expected bacterial pathogens should be instituted where necessary. The role of emerging pathogens and the effect of pneumococcal resistance and heptavalent conjugate pneumococcal vaccines are to be considered in practice. There are reports supporting the valid and highly efficacious use of penicillin as a first-line drug for treating CAP. This review raises the issue of the overuse of unnecessary antibiotics in viral CAPs and the use of second or third-line antibiotics for non-complicated pneumonias in most clinical settings.

• Archives of Plastic Surgery
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• 제51권1호
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• pp.36-41
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• 2024

Background Among breast reconstruction methods, implant-based breast reconstruction has become the mainstream. However, periprosthetic infection is still an unresolved problem. Although published articles have revealed that limited use of antibiotics is sufficient to reduce infection rates, the number of surgeons still preferring elongated usage of antibiotics is not less. The aim of our study is to validate the appropriate duration of antibiotic use to reduce infection rate after implant-based breast reconstruction. Methods A retrospective study reviewed medical record of 235 patients (274 implants for reconstruction) who underwent prepectoral direct to implant breast reconstruction using acellular dermal matrix wrapping technique. Infection rates were analyzed for the patients administered postoperative prophylactic antibiotics until drain removal and those who received only perioperative prophylactic antibiotics for 24 hours. Results Of the 274 implants, 98 who were administered prophylactic antibiotics until drain removal had an infection rate of 3.06% (three implants) and 176 who received prophylactic antibiotics no longer than 24 hours postoperatively had an infection rate of 4.49% (eight implants). A total of 11 patients diagnosed with postoperative infection clinically, 8 were salvaged by antibiotic treatment, and 3 had implant removal and replacement with autologous flap. Postoperative antibiotic prophylaxis duration had no statistically significant effects in the risk of infection (p = 0.549). Conclusion The duration of prophylactic antibiotics after surgery was not related to infection risk. Further study with a large number of patients, randomized control study, and route of antibiotics is needed.