국내 신생아중환자의 감염질환 종류에 따른 항감염제 사용 분석
Analysis of Anti-infective Drug Utilization by Type of Infectious Disease in Korean Neonatal Intensive Care Units
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Background : Antimicrobial stewardship programs (ASPs) in neonatal intensive care unit (NICU) en sures appropriate antibiotic use and enhance patient outcomes. This study aimed to support the imple mentation of ASPs for neonates by analyzing the use of anti-infective drugs according to types of neonatal infections in NICUs nationwide. Methods : Data from Korean NICU health insurance claims were analyzed, focusing on cases involving both NICU hospitalization and anti-infectives prescriptions for seven major neonatal infectious diseases: pneumonia, sepsis, meningitis, urinary tract infection, necrotizing enterocolitis, fungal infections, and viral infections. The analysis included the list of anti-infectives, the number of anti-infective prescriptions, days of therapy (DOT) of anti-infectives per claim, and the number of anti-infectives used per claim for each type of infectious disease. Results : The infection with the longest median DOT per claim was fungal infection (median 31 days, interquartile range:16-58 days). The median DOT per claim for necrotizing enterocolitis was also long at 24 days compared to 14 days for sepsis, 16 days for pneumonia, 14 days for meningitis, 14 days for urinary tract infections, and 12 days for viral infections. Analysis of the number of anti-infectives used per claim revealed that fungal infections averaged 4.18 ± 2.18 per claim and that necrotizing entero colitis averaged 3.73 ± 1.89 per claim, higher than those for other infections. In the analysis of sepsis and meningitis claims, the top seven anti-infectives were cefotaxime, ampicillin, ampicillin/sulbactam, vancomycin, gentamicin, meropenem, and amikacin. Conclusion : Korean NICUs patients were using anti-infectives active against major causative patho gens of infectious diseases, with higher usage observed in cases of necrotizing enterocolitis and fungal infections. This study established information on DOT and the list of anti-infectives used, identifying infec tious diseases and medications that require careful monitoring for implementing of effective ASP in NICUs.
Abstract
Background : Antimicrobial stewardship programs (ASPs) in neonatal intensive care unit (NICU) en sures appropriate antibiotic use and enhance patient outcomes. This study aimed to support the imple mentation of ASPs for neonates by analyzing the use of anti-infective drugs according to types of neonatal infections in NICUs nationwide. Methods : Data from Korean NICU health insurance claims were analyzed, focusing on cases involving both NICU hospitalization and anti-infectives prescriptions for seven major neonatal infectious diseases: pneumonia, sepsis, meningitis, urinary tract infection, necrotizing enterocolitis, fungal infections, and viral infections. The analysis included the list of anti-infectives, the number of anti-infective prescriptions, days of therapy (DOT) of anti-infectives per claim, and the number of anti-infectives used per claim for each type of infectious disease. Results : The infection with the longest median DOT per claim was fungal infection (median 31 days, interquartile range:16-58 days). The median DOT per claim for necrotizing enterocolitis was also long at 24 days compared to 14 days for sepsis, 16 days for pneumonia, 14 days for meningitis, 14 days for urinary tract infections, and 12 days for viral infections. Analysis of the number of anti-infectives used per claim revealed that fungal infections averaged 4.18 ± 2.18 per claim and that necrotizing entero colitis averaged 3.73 ± 1.89 per claim, higher than those for other infections. In the analysis of sepsis and meningitis claims, the top seven anti-infectives were cefotaxime, ampicillin, ampicillin/sulbactam, vancomycin, gentamicin, meropenem, and amikacin. Conclusion : Korean NICUs patients were using anti-infectives active against major causative patho gens of infectious diseases, with higher usage observed in cases of necrotizing enterocolitis and fungal infections. This study established information on DOT and the list of anti-infectives used, identifying infec tious diseases and medications that require careful monitoring for implementing of effective ASP in NICUs.