Trend of antibiotics usage for acute pyelonephritis in Korea based on national health insurance data 2010-2014

Bongyoung Kim, Rangmi Myung, Myoung Jae Lee, Jieun Kim, Hyunjoo Pai

Research output: Contribution to journalReview articlepeer-review

15 Citations (Scopus)


Background: The objective of this study is to describe the changes in prescribing practices of antibiotics to treat acute pyelonephritis (APN) in Korea. Methods: The claim data base of the Health Insurance Review and Assessment Service in Korea was used to select patients with ICD-10 codes N10 (acute tubulo-interstitial nephritis) or N12 (tubulo-interstitial nephritis, not specified as acute nor chronic) as the primary discharge diagnosis during 2010-2014. Consumption of each class of antibiotics was converted to Defined Daily Dose (DDD)/event. Results: Throughout the five-year period, the average antibiotic consumption were 11.3 DDD per inpatient event and 6.0 DDD per outpatient event. The annual average antibiotic consumption increased for inpatients (P = 0.002), but remained stable for outpatients (P = 0.066). The use of parenteral antibiotics increased for inpatients (P < 0.001), but decreased for outpatients (P = 0.017). As for the the antibiotic classes, 3rd generation cephalosporins (3rd CEPs) was the most commonly prescribed (41.4%) for inpatients, followed by fluoroquinolones (FQs) (28.5%); for outpatient, FQs (54.8%) was the most commonly prescribed, followed by 3rd CEPs (13.1%). The use of 3rd CEPs (P < 0.001), beta-lactam/beta-lactamase inhibitors (P = 0.007), and carbapenems (P < 0.001) increased substantially for the treatment of hospitalized APN patients. In particular, carbapenems use increased 3.1-fold over the 5 years. Conclusions: Prescription of broad-spectrum antibiotics increased much for the treatment of APN in Korea during 2010-2014.

Original languageEnglish
Article number554
JournalBMC infectious diseases
Issue number1
Publication statusPublished - 2019 Jun 25

Bibliographical note

Funding Information:
This work was supported by a grant from the Korea Healthcare Technology R&D Project, Nationwide surveillance system of multidrug-resistant pathogens for prevention and control of antimicrobial resistance in Korea (HI12C0756), Ministry of Health and Welfare, Republic of Korea. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Publisher Copyright:
© 2019 The Author(s).


  • Acute pyelonephritis
  • Antibiotic consumption
  • Korea
  • National health insurance
  • Resistance
  • Stewardship

ASJC Scopus subject areas

  • Infectious Diseases


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