Evaluation of Empirical Antibiotic Therapy in Women With Acute Cystitis Visiting Outpatient Clinic in South Korea

Abstract

The overuse and misuse of antibiotics are a major public health concern, contributing to the rise of antibiotic-resistant bacteria. This study aimed to determine the prevalence of inappropriate antibiotic prescription for acute uncomplicated cystitis (AUC) in primary care clinics in Korea and identify contributing factors. Data from 20- to 64-year-old female AUC patients in the Health Insurance Review and Assessment Service–National Patient Sample were analyzed. Four categories of inappropriate antibiotic use were evaluated: inappropriate selection, duration, use of parenteral antibiotics, and multiple oral antibiotics. Multiple logistic regression was used to determine the impact of factors on inappropriate prescriptions. Of the 3125 patients, 2285 (73.1%) received inappropriate antibiotics. The most common categories were the use of parenteral antibiotics. Health care facility–dependent factors were the primary contributors to inappropriate prescription. Urology-specialized clinics had more than double the rate of inappropriate prescription compared with other clinics. More than 70% of AUC patients received inappropriate antibiotics in Korean outpatient clinics. The data highlight the urgent need for antimicrobial stewardship in the outpatient setting, with AUC as a “high-priority condition.”