Infect Chemother.  2016 Sep;48(3):151-159. 10.3947/ic.2016.48.3.151.

Antibiotic Control Policies in South Korea, 2000-2013

• Kim BN
• Kim HB
• Oh MD

• KMID: 2466426
• DOI: http://doi.org/10.3947/ic.2016.48.3.151

Abstract

Antibiotic stewardship is a key strategy for limiting antibiotic resistance. Over the last decade the South Korean government has implemented a series of healthcare policies directed to this end, consisting of legislative separation of drug prescribing and dispensing, antibiotic utilization reviews, healthcare quality assessment, and public reporting. As a result, the proportion of antibiotic prescriptions for acute upper respiratory tract infections in primary healthcare facilities decreased from 72.9% in 2002 to 42.7% in 2013. However, no significant decrease in antibiotic resistance occurred over the same period in clinically important bacteria such as Streptococcus pneumoniae. These government-driven policies played a pivotal role in improving antibiotic use for outpatients and surgical patients in South Korea. However, to achieve long-lasting successful outcomes, coordinated efforts and communications among the stakeholders, including physicians and medical societies, are needed.

Keyword

Inappropriate prescribing; Bacterial drug resistance; Health policy; Drug utilization review; Health care quality assurances

MeSH Terms

Bacteria
Delivery of Health Care
Drug Prescriptions
Drug Resistance, Microbial
Drug Utilization Review
Health Policy
Humans
Inappropriate Prescribing
Korea*
Outpatients
Prescriptions
Primary Health Care
Quality Assurance, Health Care
Respiratory Tract Infections
Societies, Medical
Streptococcus pneumoniae
Utilization Review

Figure

• 

  Figure 1 Changes in antibiotic prescriptions for outpatients with acute upper respiratory tract infection in primary healthcare facilities (open circle) and tertiary hospitals (filled circle) in South Korea, 1994-2013. Figures are for the fourth quarter of each year since 2002 [111221].

• 

  Figure 2 Changes in antibiotic prescriptions as a percentage of total outpatient prescriptions in South Korea, 2002-2013. Figures are for the fourth quarter of each year from 2002 to 2008 and yearly data from 2009 to 2013 [2627].

• 

  Figure 3 Changes in perceptions of antibiotic use for acute upper respiratory tract infections in South Korea. The perceptions of primary care physicians about antibiotic use for acute upper respiratory tract infection were surveyed using clinical scenarios (A) and standardized patients (B) [28293031323334].

• 

  Figure 4 Changes in antibiotic consumption per 1000 inhabitants per day in South Korea before and after implementation of administrative antibiotic stewardship policies including separation of drug prescribing and dispensing and public reporting of antibiotic use, based on IMS data (open circle) [35] and the National Health Insurance reimbursement claims data (filled circle) [3637].

• 

  Figure 5 Changes in rates of Streptococcus pneumoniae resistance to penicillin G and erythromycin [4041424344454647]. The broken lines denote that data were not available for the corresponding periods.

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