의약분업 이후 의원 및 약국에서의 항생제 사용 실태
Patterns of Antibiotic Usage in Clinics and Pharmacy after Separation of Dispensary from Medical Practice
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초록
This study aimed to investigate the prescription of antibiotics in clinics, and evaluate their usage appropriateness after the 2000 Korean separation of dispensary from medical practice. A retrospective study was performed on the antibiotic use for 4 years from August 2000 to July 2004 in three clinics (general, internal medicine and ear-nose-and-throat (ENT) clinics). Moreover, prescription of antibiotics for acute upper respiratory infection (AURI), concomitant drugs,duplicate antibiotics and patient adherence were assessed for 260 patients experienced AURI in a pharmacy. The prescription rates of antibiotics amongst the whole prescription decreased annually during the study period, but those in ENT clinic still constituted more than 90%. The usage of penicillins declined, but that of broad spectrum antibiotics such as amoxicillin/clavulanic acid and 1st/2nd generation cephalosporins increased. Moreover, the categories of antibiotics for the same indication were different among the clinics. For patients with AURI, the more antibiotics were prescribed as its missing days and days under its therapeutic dose increased. The drug interactions with concomitant drugs decreased annually, but the use of duplicate antibiotics was similar across the period. Potential inappropriate antibiotic use was common after the Korean policy, so the observation of pharmacists needs in addition to the patients and practitioners’attention.
Abstract
This study aimed to investigate the prescription of antibiotics in clinics, and evaluate their usage appropriateness after the 2000 Korean separation of dispensary from medical practice. A retrospective study was performed on the antibiotic use for 4 years from August 2000 to July 2004 in three clinics (general, internal medicine and ear-nose-and-throat (ENT) clinics). Moreover, prescription of antibiotics for acute upper respiratory infection (AURI), concomitant drugs,duplicate antibiotics and patient adherence were assessed for 260 patients experienced AURI in a pharmacy. The prescription rates of antibiotics amongst the whole prescription decreased annually during the study period, but those in ENT clinic still constituted more than 90%. The usage of penicillins declined, but that of broad spectrum antibiotics such as amoxicillin/clavulanic acid and 1st/2nd generation cephalosporins increased. Moreover, the categories of antibiotics for the same indication were different among the clinics. For patients with AURI, the more antibiotics were prescribed as its missing days and days under its therapeutic dose increased. The drug interactions with concomitant drugs decreased annually, but the use of duplicate antibiotics was similar across the period. Potential inappropriate antibiotic use was common after the Korean policy, so the observation of pharmacists needs in addition to the patients and practitioners’attention.
참고문헌 (25)
- Dickerson LM, "The pharmacist's role in promoting optimal antimicrobial use", Pharmacotherapy, 20(6), pp.711~723 (2000)
- "약! 처방 한번 더 생각하기, 03호-항생제. 2008. 12" (2008)[URL]
- "보도자료 - 항생제처방률 50% 초반으로 낮아져. 2011. 5. 27. 석간" (2011)[URL]
- 김수경, "급성상기도감염 항생제 처방률 공개 효과 분석", 한국임상약학회지, 20(3), pp.242~247 (2010), 한국임상약학회
- MacKay DN, "Treatment of acute bronchitis in adults without underlying lung disease", J Gen Intern Med, 11, pp.557~562 (1996)
- 2009년 연보 국가항균제 내성정보, "질병관리본부", KARMS(Korean Antimicrobial Resistance Monitoring System), ~ (2011)
- 김성철, "울산 지역 소아청소년과 및 이비인후과에서의 항생제 처방 형태", 한국임상약학회지, 20(2), pp.145~150 (2010), 한국임상약학회
- 2001년 약제급여 적정성평가 결과분석, "건강보험심사평가원", ~ (2002)
- 2002년 약제급여 적정성평가 결과, "건강보험심사평가원", ~ (2003)
- 2003년 약제급여 적정성평가 결과, "건강보험심사평가원", ~ (2004)
- 2004년 약제평가 결과 종합보고, "건강보험심사평가원", ~ (2005)
- 김남순, "급성 상기도 질환에서 일차의료의사의 항생제 처방에 영향을 주는 요인", 예방의학회지, 38(1), pp.1~8 (2005), 대한예방의학회
- 2001. Active bacterial core surveillance (ABCs) report, emerging infections program network, Streptococcus pneumoniae, "Centers for Disease Control and Prevention", ~ (2000)
- "Get smart brochures Cold or flu. Antibiotics don't work for you"[URL]
- "Get smart brochuresSnort. Sniffle. Sneeze. No antibiotics please"[URL]
- "Get smart brochures Be smart. Antibiotics will not help a cold or flu"[URL]
- "Get smart onepage sheets Runny nose Q & A"[URL]
- "Treatment guidelines for upper respiratory infections adult treatment guidelines: adult appropriate antibiotic use summary"[URL]
- "Treatment guidelines for upper respiratory infections pediatric treatment guidelines: careful antibiotic use"[URL]
- 2009. Active bacterial core surveillance (ABCs) report, emerging infections program network, Streptococcus pneumoniae, "Centers for Disease Control and Prevention", ~ (2010)
- Health-Care Reform in Korea, "Jones RS", OECD Publishing, ~, pp.OECD Economics department working papers, No. 797 (2010)
- 어린이에게 항생제를 먹일 때 알아 두세요, "식품의약품안전청", ~ (2008)
- 식품의약품안전청, "올바른 항생제 사용, 건강한 대한민국" (2010)
- ECD, "Health at a glance 2011: OECD indicators" (2011), OECD Publishing
- Hueston WJ, "Why are antibiotics prescribed for patients with acute bronchitis? A postintervention analysis", J Am Board Fam Pract, 13(6), pp.398~402 (2000)