The Changing Patterns of Antibiotics Usage in Korea during 1981-2008

Youn Jeong Kim; Hyun Ji Chun; Jung Woo Lee; Kyung-Wook Hong; Sang Il Kim; Seong Heon Wie; Yang Ree Kim; Moon Won Kang

doi:10.3947/ic.2012.44.6.411

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Kim, Chun, Lee, Hong, Kim, Wie, Kim, and Kang: The Changing Patterns of Antibiotics Usage in Korea during 1981-2008

Original Article

Infection & Chemotherapy

Infection & Chemotherapy 2012; 44(6): 411-418.

Published online: 31 December 2012

DOI: https://doi.org/10.3947/ic.2012.44.6.411

The Changing Patterns of Antibiotics Usage in Korea during 1981-2008

Youn Jeong Kim, Hyun Ji Chun, Jung Woo Lee, Kyung-Wook Hong, Sang Il Kim, Seong Heon Wie, Yang Ree Kim, Moon Won Kang

Department of Internal Medicine, The Catholic University of Korea, Seoul, Korea.

Correspondence to Moon Won Kang. Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul St. Mary's Hospital, Banpo-dong 505, Seocho-gu, Seoul 137-701, Korea. Tel: +82-2-2258-6001, Fax: +82-2-3477-9193, infect@catholic.ac.kr

Received 16 December 2011 Revised 15 June 2012 Accepted 19 June 2012

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background

The actual trends in antibiotic use in Korea are difficult to determine because antibiotic usage, which is not covered by insurance or not consumed in all hospitals in Korea, cannot be calculated accurately. Therefore, this study estimated the antibiotic usage indirectly from the data available in the 'Annual Products of Medicine,' which is published by the Korean Pharmaceutical Manufacturers Association.

Materials and Methods

The data from 'Annual Products of Medicine in 2008' was analyzed. The cost and amounts of antibiotics produced were calculated and compared with previous data.

Results

In 2008, the total cost of antibiotics was $ 1.6 billion, and the total amount was 1,140 tons. Since 1993, there has been an upward trend in the total amount of antibiotics produced. In contrast, there has been a downward trend in the proportion of antibiotics among all pharmacological agents produced. In terms of the amount, the production of cephalosporins was highest since 2003, whereas the production of penicillins was highest before 2003. The production of third and fourth generation cephalosporins is increasing, whereas that of first generation cephalosporins is decreasing gradually. Regarding the class of penicillins, the production of β-lactam/β-lactamase inhibitor combinations was the highest after 2003, whereas the production of aminopenicillin was the highest before 2003. Compared to 2003, although the amount of quinolones produced in 2008 has decreased by 52.9%, the cost increased by 41.7%. This was attributed to an increase in the production of ciprofloxacin and levofloxacin instead of older quinolones. Since 1993, aminoglycoside, tetracycline, lincosamide and chloramphenicol have been decreasing in both amount and cost. The increase in carbapenems (241.9%), antifungals (128.4%) and antiviral agents (193.2%) in 2008 is remarkable compared to that in 2003.

Conclusions

The production and cost of broader spectrum and more expensive antibiotics are increasing, and is believed to be responsible for the emergence of resistance. Therefore, restriction of these broader spectrum antibiotics, such as carbapenems, is recommended.

Keywords: Anti-bacterial agents, Daily defined dose, Production, Cost, Korea

Figures and Tables

Figure 1

Changes in the Production Cost of Antibiotics from 1983 to 2008. Since 1993, there has been an upward trend in the total amount of antibiotics produced. On the other hand, there has been a downward trend in the proportion of antibiotics among all pharmacological agents produced.

Figure 2

Trend of the Production Cost and Amount of Antibiotics. (A) Production Cost of Antibitoics, (B) Production Amount of Antibiotics. The production of cephalosporins and carbapenems has been increasing steadily whereas that of aminoglycoside, tetracycline, lincosamide and chlorampheniciol has been decreasing in both amount and cost. In 2008, the production of cephalosporins comprised the highest proportion.

Figure 3

Production Cost of Anti-tuberculosis, Anti-viral and Anti-fungal agents. Production cost of antifungals and antiviral agents in 2008 is remarkably higher than that in 2003.

Table 1

The Production Cost and Amount of Penicillins

^aAntistaphylococcal penicillin: nafcillin

^bβ-lactam/β-lactamase inhibitor: amoxicillin/clavulanate, amoxicillin/sulbactam, ampicillin/sulbactam, piperacillin/sulbactam, piperacillin/tazobactam

^cAnti-pseudomonal penicillin: piperacillin

Table 2

Production of Cost and Amount Cephalosporins (Top 6 antibiotics)

Table 3

Comparisons of Cephalosporins' Production according to the Generation

^ahundred million won, ^bTon

Table 4

Production Cost of Quinolones

The unit is Hundred Million Won

^aOthers: sparfloxacin, lomefloxacin, rufloxacin, fleroxacin, pipemidic acid, pefloxacin, nalidixic acid

Table 5

Production Cost and amount of Aminoglycosides

^aThe unit is tons.