소아 급성 중이염 환자에 대한 항생제 처방 분석
Evaluation on the Antibiotics Prescriptions for the Pediatric Patients with Acute Otitis Media
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Objectives: Proper use of antibiotic for the treatment of acute otitis media (AOM) is important because it can improve the treatment effect and can reduce the risk of antibiotic-resistant bacteria. There has been no national wide study on the antibiotic use for AOM treatment in young ages in Korea. Therefore, we conducted a national wide study on the status of antibiotic prescription for the AOM treatment in young ages in Korea. Methods: The AOM outpatient data on the antibiotic prescription was obtained from Korean health insurance review and assessment service. The ratio and the factors influencing (type of AOM, patient’s age group, types of hospitals, specialty of the physician and the regions in Korea) on the antibiotic prescription was analyzed using multivariate binary logistic regression. Results: Total 388,994 cases were analyzed. The antibiotic was prescribed in 89.0%. Antibiotics were prescribed the most frequently in the pre-school ages (odds ratio [OR] 1.05; 95% confidence interval [CI], 1.00-1.11) and the least frequently in the adolescents (OR 0.81; 95% CI, 0.75-0.88). The suppurative AOM was more related to the use of antibiotics than non-suppurative AOM (OR 1.44; 95% CI, 1.39-1.50). The secondary hospital (OR 3.19; 95% CI, 2.65-3.85) and primary hospital (OR 8.40; 95% CI, 6.97-10.12) prescribed antibiotics more frequently compared to the tertiary hospital. Conclusions: Various factors are related to prescribing antibiotics for the treatment of AOM in pediatric patients. Antimicrobial prescribing guidelines for pediatric AOM patients would encourage appropriate use of antibiotics.
Abstract
Objectives: Proper use of antibiotic for the treatment of acute otitis media (AOM) is important because it can improve the treatment effect and can reduce the risk of antibiotic-resistant bacteria. There has been no national wide study on the antibiotic use for AOM treatment in young ages in Korea. Therefore, we conducted a national wide study on the status of antibiotic prescription for the AOM treatment in young ages in Korea. Methods: The AOM outpatient data on the antibiotic prescription was obtained from Korean health insurance review and assessment service. The ratio and the factors influencing (type of AOM, patient’s age group, types of hospitals, specialty of the physician and the regions in Korea) on the antibiotic prescription was analyzed using multivariate binary logistic regression. Results: Total 388,994 cases were analyzed. The antibiotic was prescribed in 89.0%. Antibiotics were prescribed the most frequently in the pre-school ages (odds ratio [OR] 1.05; 95% confidence interval [CI], 1.00-1.11) and the least frequently in the adolescents (OR 0.81; 95% CI, 0.75-0.88). The suppurative AOM was more related to the use of antibiotics than non-suppurative AOM (OR 1.44; 95% CI, 1.39-1.50). The secondary hospital (OR 3.19; 95% CI, 2.65-3.85) and primary hospital (OR 8.40; 95% CI, 6.97-10.12) prescribed antibiotics more frequently compared to the tertiary hospital. Conclusions: Various factors are related to prescribing antibiotics for the treatment of AOM in pediatric patients. Antimicrobial prescribing guidelines for pediatric AOM patients would encourage appropriate use of antibiotics.
참고문헌 (28)
- Dipiro JT, "Pharmacotherapy-a pathophysiologic approach", pp.1963~1967 (2005), McGraw-Hill
- Bluestone C, "Otitis media in infants and children", pp.73~ (2007), BC Decker
- Rosenfeld RM, "Clinical efficacy of antimicrobial drugs for acute otitis media:metaanalysis of 5400 children from thirty-three randomized trials", J Pediatr, 124(3), pp.355~367 (1994)
- Ramakrishnan K, "Diagnosis and treatment of otitis media", Am Fam Physician, 76(11), pp.1650~1658 (2007)
- Lieberthal AS, "Diagnosis and management of acute otitis media", Pediatrics, 113(5), pp.1451~1465 (2004)
- Brink AJ, "Updated recommendations for the management of upper respiratory tract infections in South Africa", S Afr Med J, 105(5), pp.344~352 (2015)
- Khanna R, "Surgical management of otitis media with effusion in children: summary of NICE guidance", Clin Otolaryngol, 33(6), pp.600~605 (2008)
- Larynx AN, "Clinical practice guidelines for the diagnosis and management of acute otitis media (AOM) in children in Japan", Auris Nasus Larynx, 39, pp.1~8 (2012)
- 이효정, "Korean Clinical Practice Guidelines: Otitis Media in Children", Journal of Korean Medical Science, 27(8), pp.835~848 (2012), 대한의학회[DOI]
- Ryborg CT, "Factors associated with antibiotic prescribing in children with otitis media", ISRN Family Med (2013)
- Geitona M, "Antibiotic prescription practices of pediatricians and pediatric residents in hospital care in Greece", Curr Drug Saf, 10(3), pp.221~226 (2015)
- Abbas S, "Differences in antibiotic prescribing between general practitioners and pediatricians in Hesse, Germany", Dtsch Med Wochenschr, 135(37), pp.1792~1797 (2010)
- Van Zuijlen DA, "National differences in incidence of acute mastoiditis: relationship to prescribing patterns of antibiotics for acute otitis media", Pediatr Infect Dis J, 20(2), pp.140~144 (2001)
- Steinmann K, "Antibiotic prescribing rates for acute otitis media in a pediatric emergency department", J Paediatr Child Health, 42(4), pp.204~205 (2006)
- McCaig LF, "Trends in Antimicrobial Prescribing Rates for Children and Adolescents", JAMA, 287(23), pp.3096~3102 (2002)
- Health Insurance Review and Assessment Service, "Evaluation on the antibiotics prescription for pediatric acute otitis media patients in 2014", Health Insurance Review and Assessment Service, 1~16 (2014)
- "ICH Harmonisedtripartiteguideline. Clinical investigation of medicinal products in the pediatric population E11"[URL]
- Korea Food and Drug Administration, "Guidelines for the Proper Use of Medication in Pediatric Patients", Korea Food and Drug Administration, 3~4 (2011)
- West BT, "Statistical and methodological issues in the analysis of complex sample survey data: practical guidance for trauma researchers", J Trauma Stress, 21(5), pp.440~447 (2008)
- Lemeshow S, "Illustration of analysis taking into account complex survey considerations: the association between wine consumption and dementia in the PAQUID study. Personnes Ages Quid", Am J Epidemiol, 148(3), pp.298~306 (1998)
- Cunningham M, "Brook I", Otitis media. Future Microbiol, 7(6), pp.733~753 (2012)
- Revai K, "Tympanometric findings in young children during upper respiratory tract infections with and without acute otitis media", Pediatr Infect Dis J, 27(4), pp.292~295 (2008)
- Hotomi M, "Factors associated with clinical outcomes in acute otitis media", Ann Otol Rhinol Laryngol, 113(10), pp.846~852 (2004)
- 최경현, "Factors Affecting the Prescribing Patterns of Antibiotics and Injections", Journal of Korean Medical Science, 27(2), pp.120~127 (2012), 대한의학회
- Thrane N, "Socioeconomic factors and prescription of antibiotics in 0- to 2-year-old Danish children", J Antimicrob Chemother, 51(3), pp.683~689 (2003)
- Mainous AG, "Antibiotics for colds in children: who are the high prescribers", Arch Pediatr Adolesc Med, 152(4), pp.349~352 (1998)
- Jacobs MR, "The Alexander Project 1998-2000: susceptibility of pathogens isolated from community-acquired respiratory tract infection to commonly used antimicrobial agents", J Antimicrob Chemother, 52(2), pp.229~246 (2003)
- Coco AS, "Trends in broad-spectrum antibiotic prescribing for children with acute otitis media in the United States, 1998-2004", BMC Pediatrics, 9, pp.41~ (2004)