J Korean Med Sci.  2024 Jul;39(29):e216. 10.3346/jkms.2024.39.e216.

Difference in Baseline Antimicrobial Prescription Patterns of Hospitals According to Participation in the National Antimicrobial Monitoring and Feedback System in Korea

• Shin J
• Park JY
• Chae J
• Kim HS
• Moon SM
• Heo E
• Park SY
• Seo DM
• Chun HJ
• Kim YC
• Lee MJ
• Huh K
• Park HJ
• Yun IJ
• Jeong SJ
• Choi JY
• Kim DS
• Kim B
• KONAS Working Committee

• KMID: 2558250
• DOI: http://doi.org/10.3346/jkms.2024.39.e216

Abstract

This study aimed to evaluate the differences in the baseline characteristics and patterns of antibiotic usage among hospitals based on their participation in the Korea National Antimicrobial Use Analysis System (KONAS). We obtained claims data from the National Health Insurance for inpatients admitted to all secondary- and tertiary-care hospitals between January 2020 and December 2021 in Korea. 15.9% (58/395) of hospitals were KONAS participants, among which the proportion of hospitals with > 900 beds (31.0% vs. 2.6%, P < 0.001) and tertiary care (50.0% vs. 5.2%, P < 0.001) was higher than that among non-participants. The consumption of antibiotics targeting antimicrobial-resistant gram positive bacteria (33.7 vs. 27.1 days of therapy [DOT]/1,000 patient-days, P = 0.019) and antibiotics predominantly used for resistant gram-negative bacteria (4.8 vs. 3.7 DOT/1,000 patient-days, P = 0.034) was higher in KONAS-participating versus -non-participating hospitals. The current KONAS data do not fully represent all secondary- and tertiary-care hospitals in Korea; thus, the KONAS results should be interpreted with caution.

Keyword

Antimicrobial Stewardship; Anti-Infective Agents; Prescription

Reference

1. Ryu S. The new Korean action plan for containment of antimicrobial resistance. J Glob Antimicrob Resist. 2017; 8:70–73. PMID: 28024981.

2. Kim B, Kim YC, Kim HS, Park SY, Choi JY. Significance of the regular publication of statistics on national health indicators in academic journals and the prospects of Korea National Antimicrobial Use Analysis System (KONAS). Infect Chemother. 2023; 55(2):306–307. PMID: 37407245.

3. Moon SM, Kim B, Kim HB. Quantitative and qualitative evaluation of antimicrobial usage: the first step for antimicrobial stewardship. Korean J Intern Med. 2024; 39(3):383–398. PMID: 38715229.

4. Lee MJ, Moon SM, Kim B, Park SY, Park JY, Koo H, et al. Status of antimicrobial stewardship programmes in Korean hospitals including small to medium-sized hospitals and the awareness and demands of physicians: a nationwide survey in 2020. J Glob Antimicrob Resist. 2021; 26:180–187. PMID: 34153526.

5. Korea National Antimicrobial Use Analysis System (KONAS). Annual report on antimicrobial use in Korean hospitals: Results of 58 participating hospitals in 2022. Accessed on 18 April 2024. https://www.konas.or.kr:44538/xe/pds/1005 .

6. Quan H, Sundararajan V, Halfon P, Fong A, Burnand B, Luthi JC, et al. Coding algorithms for defining comorbidities in ICD-9-CM and ICD-10 administrative data. Med Care. 2005; 43(11):1130–1139. PMID: 16224307.

7. World Health Organization. ATC/DDD index: Updates Included in the ATC/DDD Index, 2023. Updated 2024. Accessed September 15, 2023. https://www.whocc.no/atc_ddd_index/ .

8. Kim B, Yoon YK, Kim DS, Jeong SJ, Ahn SV, Park SH, et al. Development of antibiotic classification for measuring antibiotic usage in Korean hospitals using a modified Delphi method. J Korean Med Sci. 2020; 35(30):e241. PMID: 32743987.

9. Austin PC. An introduction to propensity score methods for reducing the effects of confounding in observational studies. Multivariate Behav Res. 2011; 46(3):399–424. PMID: 21818162.

10. Kim B, Eun BW, Lee E, Kim TH, Park S, Park SY. Professional status of infectious disease specialists in Korea: a nationwide survey. J Korean Med Sci. 2022; 37(47):e320. PMID: 36472083.

11. Kim B, Lee MJ, Moon SM, Park SY, Song KH, Lee H, et al. Current status of antimicrobial stewardship programmes in Korean hospitals: results of a 2018 nationwide survey. J Hosp Infect. 2020; 104(2):172–180. PMID: 31513880.

12. Baggs J, Fridkin SK, Pollack LA, Srinivasan A, Jernigan JA. Estimating national trends in inpatient antibiotic use among US hospitals from 2006 to 2012. JAMA Intern Med. 2016; 176(11):1639–1648. PMID: 27653796.

13. Kim B, Hwang H, Chae J, Kim YS, Kim DS. Analysis of changes in antibiotic use patterns in Korean hospitals during the COVID-19 pandemic. Antibiotics (Basel). 2023; 12(2):198. PMID: 36830109.