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 Original Articles |
| Drug Utolization Review of Antibiotics in the Geriatric Inpatients in Korea |
| Yong Kyun Cho3, Byung Joo Park1,2, Kui Oak Jung2, Hye Won Koo2, Dae Sung Kim1, and Jong Myon Bae4 |
| Department of Preventive Medicine, Seoul National University College of Medicine1, Clinical Research Center, Seoul National University Hospital2, Department of Internal Medicine, Asan Medical Center3, Department of Preventive Medicine, Cheju National University College of Medicine4 |
Vol.17 Num.1 (p11~23)
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Background : The most important problem related to antibiotic use is the emergence of antibiotic resistance, and others are toxicity of antibiotics, induction of secondary superinfections and high cost. To improve these dilemmas, appropriate antibiotic use is required. This study was designed to describe antibiotic use at community hospitals and clinics in 1993-1994 for conducting the Drug Utilization Review(DUR) of the geriatric inpatients aged 65 or more who were beneficiaries of the Korea Medical Insurance Corporation(KMIC) residing in Pusan City.
Methods : Computerized database of the drug prescription on the study population had been constructed through inputting the information on the claims data from the medical institutions to the KMIC. The outcomes of data analysis were the pattern of prescribing antibiotics including the dosage, duration of prescribed antibiotics and change of antibiotic use, and polypharmacy. The analysis was also performed by age, sex and type of medical institution.
Results : The study population consisted of 4,262 inpatients. The admission rate of geriatric population was about 9 persons/100 person-year. The proportion of patients prescribed antibiotics was 51.4%. The most frequently prescribed oral antibiotics was penicillin-derivatives, followed by quinolones and 1st generation cephalosporins. And overall, aminoglycosides and 1st generation cephalosporins were the most commonly prescribed parented antibiotics. The trend of oral antibiotics use for 2 years showed that the relative use of penicillin-derivatives decreased while that of cephalosporins increased mainly due to 2nd and 3rd generation cephalosporins. In parented antibiotics, the relative use of penicillin-derivatives and aminoglycosides decreased and that of 2nd and 3rd generation cephalosporins increased. The proportion of β-lactamase inhibitor, 2nd, 3rd generation cephlosporin and quinolone prescriptions was higher in tertiary than secondary hospitals. Over& average daily dose of antibiotics was equal in both institutions and duration of antibiotic use was longer in tertiary hospitals than secondary hospitals. The frequency of combination therapy was 56.2% and the most commonly combined antibiotics were aminoglycosides.
Conclusion : Because of high proportion of inpatients prescribed antibiotics, increased use of 2nd and 3rd generation cephalosporins and high frequency of combined aminoglycoside therapy, appropriateness of prescriptions should be studied by comparing microbial susceptibilities with antimicrobial use patterns. |
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Keywords : Drug utilization review of antibiotics, Geriatric inpatients, Pharmacoepidemiologic study |
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