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KMID : 0869619990160030380
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Journal of Korean Society of Hospital Pharmacists
1999 Volume.16 No. 3 p.380 ~ p.385
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Quantitative Analysis of the Use of Antimicrobial Agents
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이자균/Lee, Ja Kyun
조경희/반태환/박진영/Cho, Kyung Hee/Ban, Tae Hwan/Pack, Jin Young
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Abstract
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The emergence of antibiotic-resistant microorganisms is a worldwide problem and its clinical aspects are diverse among countries or clinics. Thus, for obtaining consistent data which could be used as a guide for proper usage of antimicrobial agents, we carried out present studies analyzing the total amount of antimicrobial usage, the proportions of the preventive usage and the therapeutic one, and the antimicrobial susceptibility of clinical isolates from Kangbuk Samsung Hospital. The amount of antimicrobial usage was investigated on the basis of "Individual Drug Day(IDD)" theory in 1,574 patients who had left the hospital in May, 1998. The antimicrobial susceptibility test was performed in the 1,885 isolates obtained for six months from blood samples or microorganism specimens. The usage rates for the individual antimicrobial agents were 43.0%(5579/12970 days) for cephalosporines, 38.3%(4968/12979 days) for aminoglycosides, 12.7%(1643/12979 days) for penicillins (including β-lactam inhibitor complexes), 3.9%(507/12979 days) for quinolones, 0.96%(125/12979 days) for glycopeptides, 0.86% (112/12979 days) for monobactams, and 0.11% (15/12979 days) for carbaphenems, respectively. The total usage amount of antimicrobial agents administered by injection was determined as IDDs/1000 inpatients/day. The results showed that the usage day for the individual antimicrobial agents for 1,000 inpatients a day was 266, which means that the average rate of the patients under antimicrobial treatment by injection a day was 26%. In the susceptibility tests, MRSA was isolated from both blood culture tests and general microorganisms tests at high frequencies, 62% and 70%, respectively. The data furthermore suggests that more attention needs th be paid to vancomycin-resistant S. aureus (VRSA). Of 1007 cases receiving antimicrobial treatment by injection, the usage was for the purpose of prevention in 406 cases (40.3%) and 599 cases (59.5%), including the empiric antimicrobial treatment, were therapeutic treatment. We speculate that the guideline for antimicrobial usage needed to be revised, with a management in order, on the basis of our investigations for decreasing the antimicrobial resistant incidence rates and managing the DRG in advance.
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