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논문 기본 정보

자료유형
학술저널
저자정보
Han Seung Beom (Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea.Department of Pediatrics, Bucheon St. Mary’s Hospital, College of Medicine, The Catholic Univers) Bae Kil Seong (Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea.Department of Pediatrics, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic Unive) Choi Ui Yoon (Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea.Department of Pediatrics, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic Unive) Kim Jong-Hyun (Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea.Department of Pediatrics, St. Vincent’s Hospital, College of Medicine, The Catholic University o)
저널정보
대한의학회 Journal of Korean Medical Science Journal of Korean Medical Science Vol.39 No.24
발행연도
2024.6
수록면
1 - 10 (10page)
DOI
10.3346/jkms.2024.39.e189

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초록· 키워드

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Background: Antimicrobial resistance (AMR) is an important global public health concern in adults and children. Laryngotracheobronchitis (croup) is a common acute respiratory infection (ARI) among children, most often caused by a virus, and should not be treated with antibiotics. Reducing the usage of unnecessary antibiotics in ARI using an antimicrobial stewardship program (ASP) is an effective measure against AMR in children. This study investigates the antibiotic prescription pattern in pediatric patients with laryngotracheobronchitis in Korea. Our results will be useful to improve the ASP. Methods: The data were obtained from the government agency Health Insurance Review and Assessment Service. We analyzed outpatient prescriptions issued to children ≤ 5 years of age with a first-listed diagnosis code for laryngotracheobronchitis, i.e., International Classification of Disease, 10th Revision, code J050 (croup), J040 (laryngitis), or J041 (tracheitis), during 2017–2020. For each prescription, demographic information and information about medical facilities visited (type of hospital, specialty of physician, location of hospital) were extracted. The overall antibiotic prescription rate was subsequently estimated, and multivariable analysis was conducted to determine the associated factors of antibiotic prescription. Prescribed antibiotics were described and classified into extendedspectrum penicillins, cephalosporin, and macrolides. Results: Of 2,358,194 prescriptions reviewed, 829,172 (35.2%) contained antibiotics. In the multivariable analysis, management in a hospital was the strongest factor associated with antibiotic prescription (adjusted odds ratio [aOR], 22.33; 95% confidence interval [CI], 20.87–23.89; P < 0.001), followed by management in a clinic (aOR, 12.66; 95% CI, 11.83–13.54; P < 0.001) and management in a general hospital (aOR, 8.96; 95% CI, 8.37–9.59; P < 0.001). Antibiotic prescription was also significantly associated with patients who were ≤ 2 years of age, managed by a pediatric specialist, and treated at a hospital located in a non-metropolitan region. Overall, extended-spectrum penicillins were the most frequently prescribed (18.6%) antibiotics, followed by cephalosporins (9.4%) and macrolides (8.5%). Conclusion: The results of our study suggest that ASPs need to focus on physicians in hospitals, clinics, general hospitals, and pediatric specialties. Providing education programs to these groups to increase awareness of AMR and appropriate antibiotics use could be effective ASP policy and may help to reduce unnecessary prescriptions of antibiotics for laryngotracheobronchitis among pediatric patients and therefore potentially AMR in children in Korea.
#Antibiotic #Prescription #Croup #Laryngotracheobronchitis #Upper Respiratory Infection

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