Guidelines for the Antibiotic Use in Adults with Acute Upper Respiratory Tract Infections

Yoon, Young Kyung; Park, Chan Soon; Kim, Jae Wook; Hwang, Kyurin; Lee, Sei Young; Kim, Tae Hoon; Park, Do Yang; Kim, Hyun Jun; Kim, Dong Young; Lee, Hyun Jong; Shin, Hyun Young; You, Yong; Park, Dong Ah; Kim, Shin‐Woo

doi:10.3947/ic.2017.49.4.326

Cited by 41 publications

(33 citation statements)

References 140 publications

(241 reference statements)

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“…Steroid prescription is not considered inappropriate for sinusitis (J01), laryngitis (J04), or epiglottitis (J05), according to existing studies and guidelines. The same is true for antibiotics [6,[12][13][14]. Therefore, this study defined patients with codes J00, J02, J03, J06, and J39 as common cold patients.…”

Section: Data and Study Populationmentioning

confidence: 99%

Prescription of Systemic Steroids for Acute Respiratory Infections in Korean Outpatient Settings: Overall Patterns and Effects of the Prescription Appropriateness Evaluation Policy

Kim

Kyung

2020

J Prev Med Public Health

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The objective of this study was to identify individual and institutional factors associated with the prescription of systemic steroids in patients with acute respiratory infections and to investigate the role of a policy measure aimed to reduce inappropriate prescriptions. Methods: We used data from the National Health Insurance Service-National Sample Cohort from 2006 to 2015 and focused on episodes of acute respiratory infection. Descriptive analysis and multiple logistic regression analysis were performed to identify individual-level and institution-level factors associated with the prescription of systemic steroids. In addition, steroid prescription rates were compared with antibiotic prescription rates to assess their serial trends in relation to Health Insurance Review and Assessment Service (HIRA) Prescription Appropriateness Evaluation policy. Results: Among a total of 9 460 552 episodes of respiratory infection, the steroid prescription rate was 6.8%. Defined daily doses/1000 persons/d of steroid increased gradually until 2009, but rose sharply since 2010. The steroid prescription rate was higher among ear, nose and throat specialties (13.0%) than other specialties, and in hospitals (8.0%) than in tertiary hospitals (3.0%) and other types of institutions. Following a prolonged reduction in the steroid prescription rate, this rate increased since the HIRA Prescription Appropriateness Evaluation dropped steroids from its list of evaluation items in 2009. Such a trend reversal was not observed for the prescription rate of antibiotics, which continue to be on the HIRA Prescription Appropriateness Evaluation list. Conclusions: Specialty and type of institution are important correlates of steroid prescriptions in cases of acute respiratory infection. Steroid prescriptions can also be influenced by policy measures, such as the HIRA Prescription Appropriateness Evaluation policy.

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Section: Data and Study Populationmentioning

confidence: 99%

Prescription of Systemic Steroids for Acute Respiratory Infections in Korean Outpatient Settings: Overall Patterns and Effects of the Prescription Appropriateness Evaluation Policy

Kim

Kyung

2020

J Prev Med Public Health

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“…Therefore, with this interventions, it is essential to establish local guidelines and policies for empirical prescribing. In Korea, to promote appropriate use of antibiotics, the Korea Centers for Disease Control and Prevention (KCDC) is carrying out a Policy Research Serving Project with related expert groups such as the Korean Society of Infectious Diseases, Korean Society for Chemotherapy since 2016 [ 21 , 22 ].…”

Section: Discussionmentioning

confidence: 99%

Effect of an intervention targeting inappropriate continued empirical parenteral vancomycin use: a quasi-experimental study in a region of high MRSA prevalence

et al. 2018

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BackgroundDespite vancomycin use is a major risk factor for the emergence of vancomycin resistance, it is frequently inappropriately prescribed, especially as empirical treatment. We evaluated the effect of an antimicrobial stewardship intervention targeting for inappropriate continued empirical vancomycin use.MethodsThis was a quasi-experimental study comparing vancomycin use in a 6-month pre-intervention and 6-month intervention period. If empirical vancomycin was continued for more than 96 h without documentation of beta-lactam-resistant gram-positive microorganisms, it was considered inappropriate continued empirical vancomycin use. The intervention consisted of the monitoring of appropriateness by a pharmacist and direct discussion with the prescribing physicians by infectious disease specialists when empirical vancomycin was continued inappropriately. An interrupted time series analysis was used to compare vancomycin use before and during the intervention.ResultsFollowing implementation of the intervention, overall vancomycin consumption decreased by 14.6%, from 37.6 defined daily doses (DDDs)/1000 patient-days in the pre-intervention period to 32.1 DDDs/1000 patient-days in the intervention period (P < 0.001). The inappropriate consumption of vancomycin also declined from 8.0 DDDs/1000 patient-days to 5.8 DDDs/1000 patient-days (P = 0.009).ConclusionInterventions such as direct communication with prescribing physicians and infectious disease clinicians can help reduce the inappropriate continued use of vancomycin.

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“…Upper respiratory tract infections (URTIs) is a term used to describe acute infections involving the nasal cavity, pharynx and larynx (Mungrue et al, 2009;Yoon et al, 2017). URTIs are classified according to the area of inflammation, which are tonsillitis, pharyngitis, laryngitis, sinusitis, common cold, influenza and otitis media (Centre for Clinical Practice, 2008).…”

Section: Introductionmentioning

confidence: 99%

Physician prescription practice of antibiotics for upper respiratory tract infection at Kilimanjaro Christian Medical Centre Moshi, Tanzania

Mavura¹,

Sigalla²,

Muro³

et al. 2018

Afr. J. Pharm. Pharmacol.

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Upper respiratory tract infection occurs commonly in both children and adults and is a major cause of morbidity worldwide. Inappropriate antibiotic prescription for upper respiratory tract infections is associated with increasing antibiotic resistance, healthcare costs, adverse events, and poor patient outcomes. The objective of this study was to determine physician prescription practices of antibiotics for upper respiratory tract infections at Kilimanjaro Christian Medical Center hospital in Moshi, Tanzania. This was a retrospective hospital-based cross sectional study which systematically sampled files of patients with diagnosis of upper respiratory tract infection. Information from a total of 300 patients' prescriptions were collected, reviewed and analyzed. The most common infections diagnosis was non-specific upper respiratory tract infections accounting for 102 (34.0%) followed by rhinitis and tonsillitis both accounting for 52 (17.3%) with the least being common cold 22 (7.3%). Antibiotics were prescribed to 200 (66.7%) patients with upper respiratory tract infections. Amoxicillin alone was the most preferred drug for all upper respiratory tract infections 91 (31.5%). In the multivariable logistic regression analysis, patients with cough and running nose (AOR=16.41, 95% CI: 1.95-138.19) had higher odds of being prescribed with antibiotic as compared to those without such symptoms (AOR=1.98, 95% CI: 1.04-3.77), respectively. Antibiotics are being over-prescribed among patients with upper respiratory tract infection. Interventions to reduce the over-prescription and hence overuse of antibiotics for upper respiratory tract infections are urgently needed.

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Guidelines for the Antibiotic Use in Adults with Acute Upper Respiratory Tract Infections

Cited by 41 publications

References 140 publications

Prescription of Systemic Steroids for Acute Respiratory Infections in Korean Outpatient Settings: Overall Patterns and Effects of the Prescription Appropriateness Evaluation Policy

Prescription of Systemic Steroids for Acute Respiratory Infections in Korean Outpatient Settings: Overall Patterns and Effects of the Prescription Appropriateness Evaluation Policy

Effect of an intervention targeting inappropriate continued empirical parenteral vancomycin use: a quasi-experimental study in a region of high MRSA prevalence

Physician prescription practice of antibiotics for upper respiratory tract infection at Kilimanjaro Christian Medical Centre Moshi, Tanzania

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