Background: Environmental contamination with multidrug-resistant organisms (MDROs), including carbapenem-resistant Acinetobacter baumannii (CRAB) and multidrug-resistant Pseudomonas aeruginosa (MRPA), remains a major challenge in healthcare facilities.Hypochlorous acid water (HOCl) has emerged as a promising disinfectant owing to its strong antimicrobial activity and favorable safety profile. This study aimed to evaluate the bactericidal efficacy of atomized HOCl against CRAB and MRPA in a hospital room. Methods: An atomization experiment was conducted in a two-bed room. CRAB and MRPA were prepared using drying and non-drying methods, respectively. HOCl (CLFine) at concentration of 40 and 300 ppm was atomized using ultrasonic humidifiers. Bacterial samples were collected at 0, 1, 3, and 5 h after atomization. Viable bacterial counts were determined by culture, and bactericidal efficacy was evaluated. Results: Atomized HOCl exhibited time- and concentration-dependent bactericidal effects against CRAB and MRPA. CRAB and MRPA reached their limits of detection at 3 and 5 h postatomization at 40 ppm, and at 1 and 3 h at 300 ppm, respectively. Conclusion Atomized HOCl effectively inactivated CRAB and MRPA in a hospital room within 3–5 h. These findings support the potential application of HOCl atomization as an adjunctive environmental disinfection strategy for controlling MDRO contamination in healthcare facilities.

ABSTRACT Background: Elderly patients with multimorbidity have a high prevalence of polypharmacy. Although negative consequences ofpolypharmacy have been reported, the definition of polypharmacy and inappropriate polypharmacy have not been established. The purpose of this study was to review the definition of polypharmacy and foreign countries’ interventions aimed at improving the ap-propriate use of polypharmacy in older people. We searched for relevant studies up to December 2024 using MEDLINE, Cochrane Library, and reports using Google. We also conducted web searches and literature reviews in Australia, the United Kingdom, and global organizations such as the World Health Organization (WHO). We found out that polypharmacy can refer to the prescribing ofmany drugs (appropriately) or too many drugs (inappropriately). Problematic polypharmacy was defined as ‘the prescribing of multiple [medicines] inappropriately, or where the intended benefit of the [medicines] is not realized’. Also, it is necessary to developguidance on inappropriate polypharmacy and intervention to improve drug-related problems due to polypharmacy among the elderly.

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: 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.