• Sat. Jan 22nd, 2022

The annual average antibiotic consumption increased for inpatients (are common uropathogen, and is the most common among them


Dec 1, 2021

The annual average antibiotic consumption increased for inpatients (are common uropathogen, and is the most common among them. and Assessment Service in Korea was used to select patients with ICD-10 codes N10 (acute tubulo-interstitial nephritis) or N12 (tubulo-interstitial nephritis, not specified as acute Calcium D-Panthotenate nor chronic) as the primary discharge diagnosis during 2010C2014. Consumption of each class of antibiotics was converted to Defined Daily Dose (DDD)/event. Results Throughout the five-year period, Calcium D-Panthotenate the average antibiotic consumption were 11.3 DDD per inpatient event and 6.0 DDD per outpatient event. The annual average antibiotic consumption increased for inpatients (are common uropathogen, and is the most common among them. Uropathogens from APN have become resistant to several important antibiotics such as trimethoprim/sulfamethoxazole (SXT), fluoroquinolones (FQs) and Calcium D-Panthotenate the 3rd generation cephalosporins (3rd CEPs) and antibiotic resistance of uropathogens resulted in unfavorable clinical responses in community-acquired APN [3, 4]. In Korea, the resistance rates of SXT, FQs and 3rd CEPs among for community-acquired APN were 27.8, 21.3 and 9.3%, respectively, during 2010C2012 [5]. Antibiotic use and antibiotic resistance of the pathogens are closely connected and influence each other. The aim of this study is to describe the changes in prescribing practices of antibiotics used to treat APN during 2010C2014, using the National Health Insurance claim data in Korea, which may give a clue to the overall changes in prescribing practices of antibiotics used to treat common bacterial infections. Methods Data source The National Health Insurance System of Korea covers almost the entire population, including low-income families receiving medical aid: 98% of the population was covered in 2014 [6]. We obtained the National Health Insurance claim data through the Healthcare Big Data Hub, where the Health Insurance Review & Assessment Service provides online health insurance data for fee. The data set includes information on age, gender, insurer type, clinic/hospital code, area code of clinic/hospital, care type (inpatient/outpatient), treatment start date, treatment days, admission or visit days, primary discharge diagnosis code, sub-discharge diagnosis code, medical GluA3 department in charge, medical cost, and prescribed pharmaceuticals. The discharge diagnoses were coded following the Defined daily dose, 1st generation cephalosporins, 2nd generation cephalosporins, 3rd generation cephalosporins, 4th generation cephalosporins, Aminoglycosides, Beta-lactam/beta-lactamase inhibitors, Fluoroquinolones, Trimethoprim/sulfamethoxazole For outpatients, the use of 3rd CEPs (isolated from blood in large Korean hospitals was 23.9% in 2006C2007 and then increased to 30.8% in 2011 [15]. Similarly, the resistance rate of to FQs had increased from 21.3% in 2010C2011 to 33.5% in 2017C2018 among community-acquired APN patients [5, 16]. In discussing isolated from female uncomplicated cystitis, the study also demonstrated an increase in FQs resistance [17]. These changes seem to have affected the antibiotic prescription pattern for APN treatment. We found that carbapenems use increased by 3.1-fold among inpatients (from 0.28 to 0.87 DDD/event) and by 2.1-fold among outpatients (from 0.02 to 0.04 DDD/event), respectively. Also, the proportion of carbapenems use relative to FQs (8.3% in 2010 2010; 12.6% in 2011; 16.8% in 2012; 21.7% in 2013; 28.8% in 2014) and that to 3rd CEPs (6.8% in 2010 2010; 9.4% in 2011; 11.5% in 2012; 14.0% in 2013; 16.9% in 2014) gradually increased. Carbapenems are generally used in hospital-acquired infections caused by multi-drug resistant organisms, however, our data implicates that those broad-spectrum antibiotics are more and more commonly used in mostly community-onset relatively simple infection. Considering the high prevalence of APN and ecological impact of the extensive use of carbapenems, this is a worrisome finding. Nationwide education and prescription control of broad-spectrum antibiotics for the treatment of common but not serious infections such as community-acquired APN should be reinforced. Other antibiotics which would replace carbapenems for the treatment of APN caused by extended-spectrum beta-lactamase (ESBL) producing organisms such as piperacillin/tazobactam or gentamicin should be studied more and recommended for the treatment Calcium D-Panthotenate of less Calcium D-Panthotenate severe APN patients [18, 19]. Broad-spectrum antibiotic consumption is a common problem in many countries. Based on the data from the European Surveillance of Antibiotic Consumption (ESAC) projects, broad-spectrum penicillins and BL/BLIs were used more frequently than traditional penicillins throughout the EU countries [20]. Carbapenems and polymyxin usage also increased substantially during 2009C2013 [20]. Likewise, the consumption of broad-spectrum antibiotics including 3rd CEPs and carbapenems increased in Korea since the last decade [21]. To break out of such a vicious cycle, the establishment of antimicrobial stewardship programs should be emphasized. In China, a rapid and sustained reduction in antibiotic usage was achieved by a.