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논문 기본 정보

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저자정보
Choi Yunsang (Division of Infectious Diseases Department of Internal Medicine Seoul National University Bundang Hospital Seongnam Korea.Department of Internal Medicine Seoul National University College of Medicine) Kang Minsun (Artificial Intelligence and Big-Data Convergence Centre Gil Medical Centre Gachon University College of Medicine Incheon Korea.Department of Preventive Medicine Gachon University College of Medicine I) Shin Dong Hoon (Department of Internal Medicine Seoul National University College of Medicine Seoul Korea.) Jung Jongtak (Division of Infectious Diseases Department of Internal Medicine Soonchunhyang University Seoul Hospital Soonchunhyang University College of Medicine Seoul Korea.) Choi Seong Jin (Division of Infectious Diseases Department of Internal Medicine Seoul National University Bundang Hospital Seongnam Korea.) Kim Nak-Hyun (Department of Internal Medicine Seoul National University College of Medicine Seoul Korea.) Moon Song Mi (Division of Infectious Diseases Department of Internal Medicine Seoul National University Bundang Hospital Seongnam Korea.) Song Kyoung-Ho (Division of Infectious Diseases Department of Internal Medicine Seoul National University Bundang Hospital Seongnam Korea.Department of Internal Medicine Seoul National University College of Medicine) Kim Eu Suk (Division of Infectious Diseases Department of Internal Medicine Seoul National University Bundang Hospital Seongnam Korea.Department of Internal Medicine Seoul National University College of Medicine) Jung Jaehun (Artificial Intelligence and Big-Data Convergence Centre Gil Medical Centre Gachon University College of Medicine Incheon Korea.Department of Preventive Medicine Gachon University College of Medicine I) Kim Hong Bin (Division of Infectious Diseases Department of Internal Medicine Seoul National University Bundang Hospital Seongnam Korea.Department of Internal Medicine Seoul National University College of Medicine)
저널정보
대한의학회 Journal of Korean Medical Science Journal of Korean Medical Science Vol.38 No.25
발행연도
2023.6
수록면
1 - 10 (10page)
DOI
10.3346/jkms.2023.38.e189

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Background: Although coronavirus disease 2019 (COVID-19) is a viral infection, antibiotics are often prescribed due to concerns about accompanying bacterial infection. Therefore, we aimed to analyze the number of patients with COVID-19 who received antibiotic prescriptions, as well as factors that influenced antibiotics prescription, using the National Health Insurance System database. Methods: We retrospectively reviewed claims data for adults aged ≥ 19 years hospitalized for COVID-19 from December 1, 2019 to December 31, 2020. According to the National Institutes of Health guidelines for severity classification, we calculated the proportion of patients who received antibiotics and the number of days of therapy per 1,000 patient-days. Factors contributing to antibiotic use were determined using linear regression analysis. In addition, antibiotic prescription data for patients with influenza hospitalized from 2018 to 2021 were compared with those for patients with COVID-19, using an integrated database from Korea Disease Control and Prevention Agency-COVID19-National Health Insurance Service cohort (K-COV-N cohort), which was partially adjusted and obtained from October 2020 to December 2021. Results: Of the 55,228 patients, 46.6% were males, 55.9% were aged ≥ 50 years, and most patients (88.7%) had no underlying diseases. The majority (84.3%; n = 46,576) were classified as having mild-to-moderate illness, with 11.2% (n = 6,168) and 4.5% (n = 2,484) having severe and critical illness, respectively. Antibiotics were prescribed to 27.3% (n = 15,081) of the total study population, and to 73.8%, 87.6%, and 17.9% of patients with severe, critical, and mild-to-moderate illness, respectively. Fluoroquinolones were the most commonly prescribed antibiotics (15.1%; n = 8,348), followed by third-generation cephalosporins (10.4%; n = 5,729) and beta-lactam/beta-lactamase inhibitors (6.9%; n = 3,822). Older age, COVID-19 severity, and underlying medical conditions contributed significantly to antibiotic prescription requirement. The antibiotic use rate was higher in the influenza group (57.1%) than in the total COVID-19 patient group (21.2%), and higher in severe-to-critical COVID-19 cases (66.6%) than in influenza cases. Conclusion: Although most patients with COVID-19 had mild to moderate illness, more than a quarter were prescribed antibiotics. Judicious use of antibiotics is necessary for patients with COVID-19, considering the severity of disease and risk of bacterial co-infection.
#Coronavirus Disease 2019 #Antibiotics #National Health Insurance

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