• 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.

• Korean Journal of Health Education and Promotion
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• v.11 no.2
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• pp.48-56
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• 1994

In order to study the factors influencing upon right medication of antibiotic for the consumers who can easily buy antibiotic from pharmacy, the study carried out questionnaires to 568 consumers who bought antibiotics from pharmacies located in Seoul And Kyung-gi do from the 1st of February, 1994 to the 28th of the same month. Materials have been analyzed with $X^-test$ of SAS, and its results are as follows. 1. Among 568 objects of this study, the group which can medicare antibiotic properly (the right use group of antibiotic) is 45.5% with 258, while the group which does not recognize correctly the use of antibiotic or does not have any information about it (the abuse group of antibiotic) is 54.6% with 310. 2. Knowledge for advantage of antibiotic the right use group has is high in comparing with that of the abuse group (p<0.001), and also in case of pregnancy, understanding for an adverse reaction of antibiotic is high (p<0.001). The right use group has had many chances to take health education (p<0.001), and the way to buy antibiotic is very safe (p<0.001). But there is no outstanding difference for recognition of an adverse reaction of antibiotic between two groups. 3. In comparing with the abuse group, the right use group keeps well taking time of antibiotics as directions (p<0.001), and keeping rate of antibiotic dosage is high (p<0.001). Also the experiences of an adverse reaction of antibiotic is low (p<0.001). 4. In comparing with the abuse group, the right use group has high educational backgrounds (p<0.001) and many experiences of the education for health promotion (p<0.001), while there is no difference in age, sex, and economic status. 5. In comparing with the abuse group, the right use group has taken antibiotic many times (p<0.001), and there are many antibiotic takers of his/her family (p<0.01). 6. In comparing with the abuse group, the right use group has made much effort not only to check blood pressure and the pulse (p<0.05) but also for food habits (p<0.05). But there is no outstanding difference in the effort to get health information and the effort for regular exercises between these two group. 7. In comparing with the abuse group, the right use group has made an exertion in buying foodstuffs (p<0.001). But there is no big difference in efforts to keep the good attitude for physical health and mental heath, and sleeping hours between these two group.

• Journal of the Korean Medical Association
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• v.61 no.11
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• pp.687-698
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• 2018

Inappropriate antibiotic use significantly contributes to antibiotic resistance, resulting in reduced antibiotic efficacy and an increased burden of disease. The objective of this study was to investigate the characteristics of prescribers whose antibiotics use was high and to explore factors affecting the use of antibiotics by medical institutions. This study analyzed the National Health Insurance claims data from 2015. Antibiotic prescription data were analyzed in terms of the number of defined daily doses per 1,000 patients per day, according to the World Health Organization anatomical-therapeutic-chemical classification and methodologies for measuring the defined daily dose. We investigated the characteristics of prescribers and medical institutions with high antibiotic use. Multivariate regression analyses were performed on the basis of characteristics of the medical institution (number of patients, type of medical institution [hospital or clinic], age of the physician, etc.). The number of patients and number of beds were found to be significant factors affecting antibiotic use in hospitals, and the number of patients, region, and medical department were significant factors affecting antibiotic use at the level of medical institutions. These findings are expected to help policy-makers to better target future interventions to promote prudent antibiotic prescription.

• Health Policy and Management
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• v.21 no.3
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• pp.365-380
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• 2011

This study was conducted to investigate the association between socio-demographic factors and attitudes toward antibiotic resistance and consumer's knowledge on antibiotic use for common cold. Telephone survey was conducted between June 24 and July 2, 2009, among 1,015 adults who were randomly stratified by age, sex and area. A total of 921 respondents were included in the analysis. Logistic regression was used to analyze the influence of socio-demographic factors on knowledge and attitudes. A total of 452 respondents(49.1%) recognised that they knew about antibiotic resistance and 769 respondents(83.5%) worried that antibiotic resistance is a serious problem in Korea. A total of 577 respondents(62.7%) had adequate knowledge on antibiotic use and resistance. Multiple logistic regression showed that younger age and higher education level were associated with adequate knowledge. The odds ratio of appropriate knowledge among persons with college degrees was 5.25(95% CI, 2.78-9.90) compared to those with elementary or less education. Sex and income variable were not predictors of adequate knowledge on antibiotic use and resistance. This study showed that consumers with less education had inadequate knowledge on antibiotic use for common cold. Even though consumers in their 40s and 50s thought they knew about antibiotic resistance, there is a need to improve their knowledge. Education campaigns for appropriate antibiotic use have to be differentiated among consumers with different socio-demographic characteristics.

• Preventive Nutrition and Food Science
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• v.8 no.2
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• pp.145-148
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• 2003

Many antibiotic monographs cite the induction of vaginal infections as a possible side effect. Invariably, this is believed to be due to Candide albicans, and empirical therapy is given. However, recent studies raise the question of the extent to which yeast do infect the host after antibiotic use. A double-blind, randomized, placebo-controlled study was undertaken on female patients to determine how many yeast infections occurred following 10 days antibiotic use. In addition, the study was designed to examine whether oval use of probiotic lactobacilli can reduce the risk of vaginal infection. Twenty four patients diagnosed with respiratory, oval or throat infections received one of several types of antibiotic for 10 days, and two capsules containing 10$^{9}$ dried Lactobacillus rhamnosus GR-1 and L. fermentum RC-14 from the day of commencement of antibiotic therapy for 21 days. The most commonly prescribed antibiotic was biaxin (clarithromycin). All but one patient had lactobacilli in the vagina upon entry to the study, and none developed yeast vaginitis or diarrhea during treatment or 20 days after completion of antibiotics. The mean Nugent score was higher in the placebo than the lactobacilli group (4.1 versus 2.4), and three cases of bacterial vaginosis arose (25 % incidence compared to 0% in the lactobacilli group) in the placebo group (2 receiving cefuroxime, 1 on biaxin). The study suggested that current antibiotic use is not necessarily associated with either diarrhea or yeast infection, as is often surmised. Nevertheless, daily use of probiotics was safe and could potentially reduce the risk of patients developing bacterial vaginosis after antibiotic use.

• Korean Journal of Clinical Pharmacy
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• v.20 no.1
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• pp.72-77
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• 2010

The objective of this study was to find out guardians' understanding on the antibiotic use for their children under elementary school age. Survey analysis was performed on 671 questionnaire response sheets from the guardians for children ($\leq$13 years old) attending daycare centers, kindergartens, or elementary schools located in eastern part and vicinity of Seoul, Korea. Result showed that majority of the guardians did not follow right direction for the use of antibiotic medications. About 80% of the guardians discontinued or reduced dosage of the antibiotic medications if symptoms relieved, and about 66% of them administered the drug always after meal although interval was not consistent. Furthermore, only one-fifth of the guardians understood right indication of antibiotic medications that it is of no use to take antibiotics for the treatment of common cold. About 65% of the guardians participated in this study responded that they received drug information for antibiotic medications from doctors or pharmacists. However, in terms of knowledge score regarding antibiotic drug use, their score was significantly lower than that of guardians who received the information from internet or mass media. This result suggests that patients counsel is not efficiently being practiced among healthcare professionals in the region surveyed in this study. Therefore, in conclusion, it appears that community pharmacists need to be more interactive in patients counsel when they dispense antibiotic medications.

• 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.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.18 no.3
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• pp.383-391
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• 2011

Purpose: This study was done to develop a web-based education program on appropriate antibiotic use and test the effects of the program on knowledge and attitudes towards antibiotic use in Korean adolescents. Methods: The web-based education program was developed through an extensive literature review and professional advisory meetings including technical assistance from a web-based education programmer and content experts. A convenience sample of 851 students from middle and high schools participated in the assessment of effects of the program. Knowledge and attitudes of the students towards antibiotic use and satisfaction with the web-based education program were measured. Descriptive statistics and paired t-test were used to analyze the data. Results: There were significant improvements in knowledge and attitudes towards antibiotic use following self-learning via the web-based education program in both middle and high school students. High school students demonstrated higher scores in knowledge and attitudes than middle school students. Conclusion: The results of this study indicate that this web-based education program on appropriate antibiotic use is a convenient and effective medium for self-learning in adolescents. Therefore the web-based program should be put into wide use as an effective and convenient teaching method for health education in secondary schools.

• Journal of Preventive Medicine and Public Health
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• v.43 no.3
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• pp.235-244
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• 2010

Objectives: To examine the prophylactic antibiotic use in reducing surgical site infection. Methods: This was a retrospective study for patients aged 18 years and older who underwent gastrectomy, cholecystectomy, colectomy, cesarean section and hysterectomy. The data source was quality assessment data of the Health Insurance Review & Assessment Service gathered from medical records of 302 national hospitals. Prophylactic antibiotic use was defined as: timely antibiotic administration or inappropriate antibiotic selection. We performed hierarchical logistic regression to examine the association between prophylactic antibiotic use and surgical site infection with adjustment for covariates. Results: The study population consisted of 16 348 patients (1588 gastrectomies, 2327 cholecystectomies, 1,384 colectomies, 3977 hysterectomies and 7072 cesarean sections) and surgical site infection was identified in 351 (2.1%) patients. The rates of timely antibiotic administration and inappropriate antibiotic selection varied according to procedures. Cholecystectomy patients who received timely prophylactic antibiotic had a significantly reduced risk of surgical site infection compared with those who did not receive a timely prophylactic antibiotics (OR 0.64, 95% CI=0.50-0.83), but no significant reduction was observed for other procedures. When inappropriate prophylactic antibiotics were given, the risk of surgical site infection significantly increased: 8.26-fold (95% CI=4.34-15.7) for gastrectomy, 4.73-fold (95% CI=2.09-10.7) for colectomy, 2.34-fold (95% CI=1.14-4.80) for cesarean section, 4.03-fold (95% CI=1.93-8.42) for hysterectomy. Conclusions: This study examines the association among timely antibiotic administration, inappropriate antibiotic selection and surgical site infection. Patients who received timely and appropriate antibiotics had a decreased risk of surgical site infection. Efforts to improve the timing of antibiotic administration and use of appropriate antibiotic are needed to lower the risk of surgical site infection.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.26 no.3
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• pp.135-145
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• 2023

Antibiotics are frequently administered during pregnancy. Although necessary to address acute infections, their use facilitates antibiotic resistance. Other associations have also been found with the use of antibiotics, such as perturbations of gut bacteria, delays in microbial maturation, and increased risks of allergic and inflammatory diseases. Little is known about how the prenatal and perinatal administration of antibiotics to mothers affects the clinical outcomes of their offspring. A literature search was conducted of the Cochrane, Embase, and PubMed engines. The retrieved articles were reviewed by two authors and verified for relevance. The primary outcome was the effect of pre- and perinatal maternal antibiotic use on clinical outcomes. Thirty-one relevant studies were included in the meta-analysis. Various aspects are discussed, including infections, allergies, obesity, and psychosocial factors. In animal studies, antibiotic intake during pregnancy has been suggested to cause long-term alterations in immune regulation. In humans, associations have been found between antibiotic intake during pregnancy and different types of infections and an increased risk of pediatric infection-related hospitalization. A dose-dependent positive association between pre- and perinatal antibiotic use and asthma severity has been reported in animal and human studies, while positive associations with atopic dermatitis and eczema were reported by human studies. Multiple associations were identified between antibiotic intake and psychological problems in animal studies; however, relevant data from human studies are limited. However, one study reported a positive association with autism spectrum disorders. Multiple animal and human studies reported a positive association between pre- and perinatal antibiotic use by mothers and diseases in their offspring. Our findings have potentially significant clinical relevance, particularly considering the implications for health during infancy and later in life as well as the related economic burden.