Nationwide Use of Antibiotics in Korean Ambulatory Pediatrics

Abstract

1. Background Information on the use of antibiotics in Eastern Asian children is limited. The objectives of this study were to evaluate the nationwide pattern of prescribing broad-spectrum antibiotics, and the potential appropriateness of antibiotic use for acute respiratory tract infections in Korean paediatric outpatients according to age groups and medical institutions. 2. Method The population-based study used the national insurance reimbursement database in 2011. The study subjects were outpatients younger than 18 years old prescribed systemic antibiotics. Patterns of antibiotic prescription were compared according to diagnostic conditions, age groups, and medical institutions. The factors affecting broad-spectrum antibiotic prescriptions were also analysed. The potential appropriateness of antibiotic use for acute respiratory tract infections was evaluated based on clinical practice guidelines. The antibiotics were potentially appropriate if they were recommended as first/second-line agents. 3. Results The data consisted of 70.7 million prescription records for 7.9 million paediatric outpatients. Broad-spectrum antibiotics comprised 78.5% of the prescriptions, with broad-spectrum penicillin such as amoxicillin/clavulanate being the most prescribed (50.2%). Factors associated with broad-spectrum antibiotic use were acute respiratory infections and younger age groups. A proportion of prescribed antibiotics for acute respiratory infections for which antibiotics are rarely indicated was 51.4%. Most of these prescriptions were for and acute bronchitis with broad-spectrum antibiotics. 4. Conclusions This study found that broad-spectrum antibiotics were commonly prescribed in Korean paediatric outpatients, and its potential misuse was frequent for acute respiratory diseases. Antibiotic use in children in Korea is inappropriately high. Additionally, broad spectrum antibiotics are used excessively.