• The Korean journal of internal medicine
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• 제39권3호
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• pp.373-382
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• 2024

This review addresses the escalating challenge posed by antibiotic resistance, highlighting its profound impact on global public health, including increased mortality rates and healthcare expenditures. The review focuses on the need to adopt the One Health approach to effectively manage antibiotic usage across human, animal, and environmental domains. Antimicrobial stewardship programs (ASPs) are considered as comprehensive strategies that encompass both core and supplementary initiatives aimed at enhancing prudent antibiotic use. The 2021 "Guidelines on Implementing ASP in Korea" introduced such strategies, with a strong emphasis on fostering multidisciplinary and collaborative efforts. Furthermore, the "Core Elements for Implementing ASPs in Korean General Hospitals," established in 2022, provide a structured framework for ASPs, delineating leadership responsibilities, the composition of interdisciplinary ASP teams, a range of interventions, and continuous monitoring and reporting mechanisms. In addition, this review examines patient-centric campaigns such as "Speak Up, Get Smart" and emphasizes the pivotal role of a multidisciplinary approach and international cooperation in addressing the multifaceted challenges associated with antibiotic resistance.

• 한국문헌정보학회지
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• 제32권3호
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• pp.143-156
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• 1998

이 논문은 미국 초중고교 교사들을 이용 대상자로 인터넷 상에 산재해 있는 강의안 및 교육자료의 메타데이터 DB를 구축한 GEM 프로젝트에 대한 보고이다. GEM 프로젝트에서는 현재 거의 표준으로 간주되는 더블린 코어의 15개 요소(Elements)를 채택하였고, 여기에 8개 요소를 첨가하여 검색을 원활히 하고자 하였다. GEM 메타데이터 DB의 구축에는 메타데이터 요소들간의 관계를 좀 더 명확히 표현할 수 있는 개념적 데이터 마들링을 사용하였고 메타데이터는 Sybase라는 관계형 데이터베이스에 저장했으며, 이 DB에 웹 인터페이스를 장착하는데에는 Microsoft 액티브 서버 페이지 (ASP) 기술을 이용하였다. GEM 메타데이터의 실제목록은 미국 전역에서 참가하고있는 컨소시엄 회원들에 의해서 이뤄지고 있으며, 그 결과는 인터넷을 통해 Sybase 관계형 데이터베이스에 자동적으로 입력된다. 이 논문에서는 더블린코어, GEM의 개념 및 논리 스키마들을 제시하는 한편, 메타데이터 DB의 구축에 개념적 데이터 마들링을 사용함으로써 얻어지는 장점들을 논하였다. GEM 프로토타입 시스템이 가동되고 있는 URL은 다음과 같다: http://lis.skku.ac.kr/gem/.

• 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.