Background: Many pregnant women receive antibiotic treatment for infections. We investigated the association between quinolone use in the first trimester of pregnancy and the risk of adverse health outcomes for the child in Korea. Materials and Methods: This nationwide, population-based cohort study used data on mother-child pairs from the National Health Insurance claims database. This study cohort included 2,177,765 pregnancies from January 1, 2011, to December 31, 2020, and 87,456 women were prescribed quinolones during pregnancy. After propensity score matching, the final number of study subjects was 84,365 for both quinolone and non-antibiotic users. We examined the subjects’ exposure to quinolone antibiotics. The main outcome measures were absolute and relative risks of atopic dermatitis, asthma, and allergies. We adjusted for potential confounders. Results: Quinolones were prescribed at least once during the first trimester in 4.01% of pregnancies. Quinolone users had significantly higher absolute risks than non-antibiotic users for atopic dermatitis, asthma, and allergies, with significantly elevated risk ratios (RRs) for these conditions (atopic dermatitis: RR, 1.09; 95% confidence interval [CI], 1.08–1.11, asthma: RR, 1.04; 95% CI, 1.03–1.05, and allergies: RR, 1.10; 95% CI, 1.08–1.13). Conclusion We found that quinolone exposure during the first trimester of pregnancy increased the risk of atopic dermatitis, asthma, and allergies. This study could provide physicians with useful information when selecting antibiotics for pregnant women.

Background: Many pregnant women receive antibiotic treatment for infections. We investigated the association between quinolone use in the first trimester of pregnancy and the risk of adverse health outcomes for the child in Korea. Materials and Methods: This nationwide, population-based cohort study used data on mother-child pairs from the National Health Insurance claims database. This study cohort included 2,177,765 pregnancies from January 1, 2011, to December 31, 2020, and 87,456 women were prescribed quinolones during pregnancy. After propensity score matching, the final number of study subjects was 84,365 for both quinolone and non-antibiotic users. We examined the subjects’ exposure to quinolone antibiotics. The main outcome measures were absolute and relative risks of atopic dermatitis, asthma, and allergies. We adjusted for potential confounders. Results: Quinolones were prescribed at least once during the first trimester in 4.01% of pregnancies. Quinolone users had significantly higher absolute risks than non-antibiotic users for atopic dermatitis, asthma, and allergies, with significantly elevated risk ratios (RRs) for these conditions (atopic dermatitis: RR, 1.09; 95% confidence interval [CI], 1.08–1.11, asthma: RR, 1.04; 95% CI, 1.03–1.05, and allergies: RR, 1.10; 95% CI, 1.08–1.13). Conclusion We found that quinolone exposure during the first trimester of pregnancy increased the risk of atopic dermatitis, asthma, and allergies. This study could provide physicians with useful information when selecting antibiotics for pregnant women.

Background: Many pregnant women receive antibiotic treatment for infections. We investigated the association between quinolone use in the first trimester of pregnancy and the risk of adverse health outcomes for the child in Korea. Materials and Methods: This nationwide, population-based cohort study used data on mother-child pairs from the National Health Insurance claims database. This study cohort included 2,177,765 pregnancies from January 1, 2011, to December 31, 2020, and 87,456 women were prescribed quinolones during pregnancy. After propensity score matching, the final number of study subjects was 84,365 for both quinolone and non-antibiotic users. We examined the subjects’ exposure to quinolone antibiotics. The main outcome measures were absolute and relative risks of atopic dermatitis, asthma, and allergies. We adjusted for potential confounders. Results: Quinolones were prescribed at least once during the first trimester in 4.01% of pregnancies. Quinolone users had significantly higher absolute risks than non-antibiotic users for atopic dermatitis, asthma, and allergies, with significantly elevated risk ratios (RRs) for these conditions (atopic dermatitis: RR, 1.09; 95% confidence interval [CI], 1.08–1.11, asthma: RR, 1.04; 95% CI, 1.03–1.05, and allergies: RR, 1.10; 95% CI, 1.08–1.13). Conclusion We found that quinolone exposure during the first trimester of pregnancy increased the risk of atopic dermatitis, asthma, and allergies. This study could provide physicians with useful information when selecting antibiotics for pregnant women.

Background: Data on antimicrobial use at the national level are crucial for establishing domestic antimicrobial stewardship policies and enabling medical institutions to benchmark each other. This study aimed to analyze antimicrobial use in Korean hospitals. Materials and Methods: We investigated antimicrobials prescribed in Korean hospitals between 2018 and 2021 using data from the Health Insurance Review and Assessment. Primary care hospitals (PCHs), secondary care hospitals (SCHs), and tertiary care hospitals (TCHs) were included in this analysis. Antimicrobials were categorized according to the Korea National Antimicrobial Use Analysis System (KONAS) classification, which is suitable for measuring antimicrobial use in Korean hospitals. Results: Among over 1,900 hospitals, PCHs constituted the highest proportion, whereas TCHs had the lowest representation. The most frequently prescribed antimicrobials in 2021 were piperacillin/β-lactamase inhibitor (9.3%) in TCHs, ceftriaxone (11.0%) in SCHs, and cefazedone (18.9%) in PCHs. Between 2018 and 2021, the most used antimicrobial classes according to the KONAS classification were ‘broad-spectrum antibacterial agents predominantly used for community-acquired infections’ in SCHs and TCHs and 'narrow spectrum beta-lactam agents' in PCHs. Total consumption of antimicrobials decreased from 951.7 to 929.9 days of therapy (DOT)/1,000 patient-days in TCHs and 817.8 to 752.2 DOT/1,000 patient-days in SCHs during study period; however, no reduction was noted in PCHs (from 504.3 to 527.2 DOT/1,000 patient-days). Moreover, in 2021, the use of reserve antimicrobials decreased from 13.6 to 10.7 DOT/1,000 patient-days in TCHs and from 4.6 to 3.3 DOT/1,000 patient-days in SCHs. However, in PCHs, the use increased from 0.7 to 0.8 DOT/1,000 patient-days. Conclusion This study confirmed that antimicrobial use differed according to hospital type in Korea. Recent increases in the use of total and reserve antimicrobials in PCHs reflect the challenges that must be addressed.

This study aimed to evaluate the differences in the baseline characteristics and patterns of antibiotic usage among hospitals based on their participation in the Korea National Antimicrobial Use Analysis System (KONAS). We obtained claims data from the National Health Insurance for inpatients admitted to all secondary- and tertiary-care hospitals between January 2020 and December 2021 in Korea. 15.9% (58/395) of hospitals were KONAS participants, among which the proportion of hospitals with > 900 beds (31.0% vs.2.6%, P < 0.001) and tertiary care (50.0% vs. 5.2%, P < 0.001) was higher than that among non-participants. The consumption of antibiotics targeting antimicrobial-resistant gram positive bacteria (33.7 vs. 27.1 days of therapy [DOT]/1,000 patient-days, P = 0.019) and antibiotics predominantly used for resistant gram-negative bacteria (4.8 vs. 3.7 DOT/1,000 patient-days, P = 0.034) was higher in KONAS-participating versus -non-participating hospitals. The current KONAS data do not fully represent all secondary- and tertiary-care hospitals in Korea; thus, the KONAS results should be interpreted with caution.

Background: The Korea National Antimicrobial Use Analysis System (KONAS), a benchmarking system for antimicrobial use in hospitals, provides Korean Standardized Antimicrobial Administration Ratio (K-SAAR) for benchmarking. This article describes K-SAAR predictive models to enhance the understanding of K-SAAR, an important benchmarking strategy for antimicrobial usage in KONAS. Methods: We obtained medical insurance claims data for all hospitalized patients aged ≥ 28 days in all secondary and tertiary care hospitals in South Korea (n = 347) from January 2019 to December 2019 from the Health Insurance Review & Assessment Service. Modeling was performed to derive a prediction value for antimicrobial use in each institution, which corresponded to the denominator value for calculating K-SAAR. The prediction values of antimicrobial use were modeled separately for each category, for all inpatients and adult patients (aged ≥ 15 years), using stepwise negative binomial regression. Results: The final models for each antimicrobial category were adjusted for different significant risk factors. In the K-SAAR models of all aged patients as well as adult patients, most antimicrobial categories included the number of hospital beds and the number of operations as significant factors, while some antimicrobial categories included mean age for inpatients, hospital type, and the number of patients transferred from other hospitals as significant factors. Conclusion We developed a model to predict antimicrobial use rates in Korean hospitals, and the model was used as the denominator of the K-SAAR.

Purpose: The prevalence of Group B Streptococcus (GBS) colonization in pregnant Korean women is increasing; however, nationwide studies are lacking. Therefore, we aimed to analyze regional colonization rates and antimicrobial susceptibility for GBS in pregnant Korean women through a nationwide survey. Materials and Methods: From January 2018 to December 2020, data from the Seoul Clinical Laboratories on vaginal swab cultures were retrospectively analyzed to detect maternal GBS carriers. Each swab specimen was inoculated onto a 5% blood agar plate and incubated at 35°C–37°C in a 5% CO 2 incubator for 24 h. GBS isolates were identified using a Microflex MALDI Biotyper. Antimicrobial susceptibility tests were performed using the Vitek 2 automated system. Results: The overall nationwide GBS colonization rate in pregnant Korean women was found to be 10.6% (3578/33721). The maternal GBS colonization rates ranged from 10.5%–10.8% over the 3-year study period. The GBS colonization rates by province, in descending order, were as follows: Jeolla-do, 13.2%; Gangwon-do, 12.0%; Chungcheong-do, 11.8%; Gyeonggi-do, 11.3%; Seoul, 10.2%; and Gyeongsang-do, 9.6%. During the study period, the resistance rates against chloramphenicol, levofloxacin, clindamycin, erythromycin, and tetracycline were 2.6%–2.7%, 18.2%–19.6%, 33.4%–35.7%, 35.6%–36.8%, and 50.5%–53.3%, respectively. Conclusion In pregnant Korean women, GBS colonization rates were in the range of 9.6%–13.2%, with Gyeongsang-do being the lowest and Jeolla-do the highest. The resistance rate against clindamycin was high (33.4%–35.7%). GBS colonization rates during pregnancy should be studied nationwide according to the Centers for Disease Control and Prevention-recommended guidelines with periodic antimicrobial resistance monitoring.