PDF(Pubmed)
Abstract：
BACKGROUND: Acute bronchiolitis, the most common lower respiratory tract infection in infants, is mostly caused by respiratory viruses. However, antibiotics are prescribed to about 25% of children with acute bronchiolitis. This inappropriate use of antibiotics for viral infections induces antibiotic resistance. This study aimed to determine the antibiotic prescription rate and the factors associated with antibiotic use in children with acute bronchiolitis in Korea, where antibiotic use and resistance rates are high.
METHODS: Healthcare data of children aged < 24 months who were diagnosed with acute bronchiolitis between 2016 and 2019 were acquired from the National Health Insurance system reimbursement claims data. Antibiotic prescription rates and associated factors were evaluated.
RESULTS: A total of 3,638,424 visits were analyzed. The antibiotic prescription rate was 51.8%, which decreased over time (P < 0.001). In the multivariate analysis, toddlers (vs. infants), non-capital areas (vs. capital areas), primary clinics and non-tertiary hospitals (vs. tertiary hospitals), inpatients (vs. outpatients), and non-pediatricians (vs. pediatricians) showed a significant association with antibiotic prescription (P < 0.001). Fourteen cities and provinces in the non-capital area exhibited a wide range of antibiotic prescription rates ranging from 41.2% to 65.4%, and five (35.7%) of them showed lower antibiotic prescription rates than that of the capital area.
CONCLUSIONS: In Korea, the high antibiotic prescription rates for acute bronchiolitis varied by patient age, region, medical facility type, clinical setting, and physician specialty. These factors should be considered when establishing strategies to promote appropriate antibiotic use.
METHODS: Healthcare data of children aged < 24 months who were diagnosed with acute bronchiolitis between 2016 and 2019 were acquired from the National Health Insurance system reimbursement claims data. Antibiotic prescription rates and associated factors were evaluated.
RESULTS: A total of 3,638,424 visits were analyzed. The antibiotic prescription rate was 51.8%, which decreased over time (P < 0.001). In the multivariate analysis, toddlers (vs. infants), non-capital areas (vs. capital areas), primary clinics and non-tertiary hospitals (vs. tertiary hospitals), inpatients (vs. outpatients), and non-pediatricians (vs. pediatricians) showed a significant association with antibiotic prescription (P < 0.001). Fourteen cities and provinces in the non-capital area exhibited a wide range of antibiotic prescription rates ranging from 41.2% to 65.4%, and five (35.7%) of them showed lower antibiotic prescription rates than that of the capital area.
CONCLUSIONS: In Korea, the high antibiotic prescription rates for acute bronchiolitis varied by patient age, region, medical facility type, clinical setting, and physician specialty. These factors should be considered when establishing strategies to promote appropriate antibiotic use.
摘要：
背景：急性细支气管炎，婴儿最常见的下呼吸道感染，主要是由呼吸道病毒引起的。然而,约有25%的急性细支气管炎患儿使用抗生素.这种对病毒感染不适当使用抗生素会引起抗生素耐药性。这项研究旨在确定韩国急性细支气管炎患儿的抗生素处方率和与抗生素使用相关的因素。抗生素使用和耐药率很高的地方。
方法：2016年至2019年间被诊断为急性细支气管炎的24个月以下儿童的医疗保健数据来自国家健康保险系统报销索赔数据。评估抗生素处方率和相关因素。
结果：共分析了3,638,424次就诊。抗生素处方率为51.8%,随着时间的推移而下降（P<0.001）。在多变量分析中，幼儿（与婴儿)，非资本地区(与首都地区)，初级诊所和非三级医院(vs.三级医院)，住院患者(vs.门诊病人)，和非儿科医生(vs.儿科医生）与抗生素处方显着相关（P<0.001）。非首都地区的十四个城市和省份的抗生素处方率范围从41.2％到65.4％，其中5人(35.7%)的抗生素处方率低于首都地区。
结论：在韩国，急性细支气管炎的高抗生素处方率因患者年龄而异，区域,医疗设施类型,临床设置，和医师专业。在制定促进适当使用抗生素的策略时，应考虑这些因素。
方法：2016年至2019年间被诊断为急性细支气管炎的24个月以下儿童的医疗保健数据来自国家健康保险系统报销索赔数据。评估抗生素处方率和相关因素。
结果：共分析了3,638,424次就诊。抗生素处方率为51.8%,随着时间的推移而下降（P<0.001）。在多变量分析中，幼儿（与婴儿)，非资本地区(与首都地区)，初级诊所和非三级医院(vs.三级医院)，住院患者(vs.门诊病人)，和非儿科医生(vs.儿科医生）与抗生素处方显着相关（P<0.001）。非首都地区的十四个城市和省份的抗生素处方率范围从41.2％到65.4％，其中5人(35.7%)的抗生素处方率低于首都地区。
结论：在韩国，急性细支气管炎的高抗生素处方率因患者年龄而异，区域,医疗设施类型,临床设置，和医师专业。在制定促进适当使用抗生素的策略时，应考虑这些因素。
