Journal of Infection and Public Health最新文献

{"title":"Comparative analysis of colistin and polymyxin B minimal inhibitory concentrations in Enterobacterales, Acinetobacter baumannii, and Pseudomonas aeruginosa","authors":"Yu-Shan Huang ,&nbsp;Jann-Tay Wang ,&nbsp;Yu-Chung Chuang ,&nbsp;Wang-Huei Sheng ,&nbsp;Shan-Chwen Chang","doi":"10.1016/j.jiph.2025.103091","DOIUrl":"10.1016/j.jiph.2025.103091","url":null,"abstract":"<div><h3>Background</h3><div>Studies comparing colistin and polymyxin B minimum inhibitory concentrations (MICs), as well as their correlation and agreement, using non-commercial broth microdilution methods, remain limited. This study evaluated the <em>in vitro</em> susceptibilities of two polymyxins against clinically important Gram-negative bacteria.</div></div><div><h3>Methods</h3><div>Between 2018 and 2022, 891 <em>Enterobacterales</em>, 100 <em>Acinetobacter baumannii</em>, and 100 <em>Pseudomonas aeruginosa</em> clinical isolates from a tertiary hospital were tested for MICs of colistin and polymyxin B using broth microdilution. MIC correlation, categorical agreement (CA), essential agreement (EA), and directional discrepancies were assessed.</div></div><div><h3>Results</h3><div>Non-resistant rates of colistin for <em>Enterobacterales</em>, <em>A. baumannii</em>, and <em>P. aeruginosa</em> were 90.2 %, 99 %, and 98 %, respectively; those of polymyxin B were 90.5 %, 99 %, and 100 %. Carbapenem-resistant <em>Enterobacterales</em> had higher resistance to both agents (26 %). Colistin and polymyxin B showed identical MIC₅₀/MIC₉₀ values against <em>Enterobacterales</em> (0.25/2 mg/L) and <em>A. baumannii</em> (0.25/1 mg/L). Regarding <em>P. aeruginosa</em>, MIC₅₀/MIC₉₀ values were 1/1 mg/L and 0.5/1 mg/L, respectively. MICs were highly correlated (Spearman’s ρ=0.669, <em>p</em> &lt; 0.001), with CA and EA ≥ 96 % across species. Using colistin to predict polymyxin B susceptibility yielded low very major error (VME) and major error (ME) rates. Conversely, elevated VMEs occurred when using polymyxin B to infer colistin susceptibility, particularly in <em>A. baumannii</em> (100 %) and <em>P. aeruginosa</em> (50 %), though these reflected very small numbers of colistin-resistant isolates (<em>A. baumannii</em>, n = 1; <em>P. aeruginosa</em>, n = 2).</div></div><div><h3>Conclusions</h3><div>Colistin and polymyxin B showed comparable <em>in vitro</em> activity and high MIC correlation. Colistin reliably predicted polymyxin B susceptibility, but caution is needed when inferring colistin susceptibility from polymyxin B results.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 2","pages":"Article 103091"},"PeriodicalIF":4.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145733551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The clinical manifestations and laboratory test results of Brucella melitensis and Brucella abortus in acute brucellosis patients","authors":"Kun Li ,&nbsp;Dawei Cheng ,&nbsp;Xihong Sun ,&nbsp;Huijie Zhang ,&nbsp;Bing Zhang ,&nbsp;Tao Zheng ,&nbsp;Xun Zhou ,&nbsp;Wenguo Jiang ,&nbsp;Bilal Tursun ,&nbsp;Hai Jiang","doi":"10.1016/j.jiph.2025.103031","DOIUrl":"10.1016/j.jiph.2025.103031","url":null,"abstract":"<div><h3>Background</h3><div>Brucellosis is an emerging zoonotic disease worldwide. <em>Brucella melitensis, Brucella abortus</em>, <em>Brucella suis</em>, and <em>Brucella canis</em> are the main etiologic agents causing human brucellosis. It has been considered that <em>Brucella melitensis</em> is the most virulent <em>Brucella</em> species but relative studies are rare. We try to verify this viewpoint by comparing the clinical manifestations and laboratory test results of patients infected with different <em>Brucella</em> species.</div></div><div><h3>Methods</h3><div>In this study, blood samples of acute brucellosis patients were collected in four locations in China. A culture-independent nested PCR method for simultaneous detection and differentiation of <em>B. melitensis</em> and <em>B. abortus</em> was designed and applied to determine the etiologic <em>Brucella</em> species. The clinical manifestations and laboratory test data of the patients were then collected and analyzed.</div></div><div><h3>Results</h3><div>A total of 349 blood samples were collected and 55 <em>Brucella</em> strains (38 <em>B. melitensis</em> and 17 <em>B. abortus</em>) were identified. For patients infected with <em>B. abortus</em>, the proportions of fatigue, arthralgia, and sweating are apparently higher. For patients infected with <em>B. melitensis</em>, larger proportions of decreased eosinophils and elevated CRP were observed.</div></div><div><h3>Conclusions</h3><div>Our results indicated that it may not be appropriate to claim that <em>Brucella melitensis</em> is the most virulent <em>Brucella</em> species. <em>Brucella abortus</em> and <em>B. melitensis</em> just result in different clinical manifestations and laboratory test results in humans.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 2","pages":"Article 103031"},"PeriodicalIF":4.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145537553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dynamic shifts in outpatient antibiotic prescribing for pediatric upper respiratory infections in South Korea, 2002–2019: A national cohort study","authors":"Jeewon Shin ,&nbsp;Eunkyo Ha ,&nbsp;Ju Hee Kim ,&nbsp;Boeun Han ,&nbsp;Eun Lee ,&nbsp;Won Seok Lee ,&nbsp;Man Yong Han","doi":"10.1016/j.jiph.2025.103078","DOIUrl":"10.1016/j.jiph.2025.103078","url":null,"abstract":"<div><h3>Background</h3><div>Antibiotic resistance is a global health concern, driven by inappropriate use. Contemporary data on antibiotic prescribing patterns for pediatric upper respiratory infections (URIs) are needed to evaluate trends and guide stewardship efforts. We examined longitudinal trends in antibiotic prescribing for pediatric URIs in South Korea, stratified by antibiotic class and patient age group.</div></div><div><h3>Methods</h3><div>We conducted a retrospective study using the National Health Insurance Service (NHIS) pediatric sample cohort in South Korea (2002–2019). The dataset included 639,702 outpatient visits with a primary URI diagnosis among 369,702 children &lt; 18 years. Children with complex chronic conditions were excluded, and antibiotic prescriptions were grouped into six classes. Primary outcomes were the antibiotic prescribing rate (per URI visit) and antibiotic exposure days (per 1000 person-years), stratified by age group and antibiotic class. Temporal trends were assessed using joinpoint regression to estimate annual percent change (APC) and average annual percent change (AAPC).</div></div><div><h3>Results</h3><div>The proportion of antibiotic prescriptions for pediatric URIs declined from 80.2 % to 49.1 % (APC −0.27 % per year; 95 % CI −0.62–0.04). Narrow-spectrum penicillin use decreased, macrolide remained relatively stable, and broad-spectrum penicillin initially increased and later stabilized. Antibiotic exposure days per 1000 person-years increased overall (AAPC 1.88 %, 95 % CI 1.59–2.21), with the highest exposure in children aged 1–5 years, peaking around 2008 before gradually declining. Other age groups were largely stable.</div></div><div><h3>Conclusion</h3><div>Antibiotic prescribing declined modestly overall, while broad-spectrum penicillin increased and narrow-spectrum agents decreased, with exposure highest in children aged 1–5 years. Sustained outpatient stewardship is needed to reduce unnecessary use and prioritize narrow-spectrum therapy when indicated.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 2","pages":"Article 103078"},"PeriodicalIF":4.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145681958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MECHANISMS OF LINEZOLID NON-SUSCEPTIBILITY AMONG ENTEROCOCCUS FAECIUM ISOLATES FROM MULTIPLETERTIARY CARE CENTERS IN INDIA","authors":"Madhan Sugumar ,&nbsp;Sujatha Sistla ,&nbsp;Meerabai Manoharan ,&nbsp;Sree Ramchandra Murthy ,&nbsp;Kamini Walia ,&nbsp;ICMR AMR Study Group","doi":"10.1016/j.jiph.2025.103101","DOIUrl":"10.1016/j.jiph.2025.103101","url":null,"abstract":"","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 2","pages":"Article 103101"},"PeriodicalIF":4.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145925123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"INVESTIGATION OF CRISPR-CAS SYSTEMS IN PSEUDOMONAS AERUGINOSA AND THEIR ROLE IN ANTIBIOTIC RESISTANCE MECHANISMS","authors":"Amna Ahmad ,&nbsp;Muhammad I. Nasar ,&nbsp;Farah Al-Marzooq","doi":"10.1016/j.jiph.2025.103099","DOIUrl":"10.1016/j.jiph.2025.103099","url":null,"abstract":"","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 2","pages":"Article 103099"},"PeriodicalIF":4.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145925126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of sodium-glucose co-transporter 2 inhibitors on the incidence of non-tuberculous mycobacteria infection in diabetes populations","authors":"Ping-Huai Wang ,&nbsp;Chung-Han Ho ,&nbsp;Kuang-Ming Liao ,&nbsp;Chung-Shu Lee ,&nbsp;Yu-Cih Wu ,&nbsp;Chin-Chung Shu","doi":"10.1016/j.jiph.2025.103089","DOIUrl":"10.1016/j.jiph.2025.103089","url":null,"abstract":"<div><h3>Purpose</h3><div>Sodium glucose co-transporter 2 inhibitors (SGLT2i) not only control blood sugar but also exhibit cardiovascular and renal protection via inflammation modulation. But there is scarce information about the impact of SGLT2i on infections, especially non-tuberculous mycobacteria (NTM) infection.</div></div><div><h3>Methods</h3><div>This retrospective study screened the Taiwan National Health Insurance Research Database from 2016 to 2021, and enrolled subjects aged more than 20 years with initial diagnoses of type 2 diabetes mellitus (T2DM) in 2017–2021. The subjects were categorized into two groups based on whether SGLT2i were used (SGLT2i and non-SGLT2i users).</div></div><div><h3>Results</h3><div>A total of 853720 subjects were enrolled. Of these, 91181 individuals were identified as the SGLT2i users, while the remaining 762539 were classified as the non-SGLT2i users. The prevalence of NTM infection was lower in the SGLT2i users than in the non-SGLT2i (0.05 % v. 0.14 %, p &lt; 0.001). Multivariable analysis of factors associated with NTM infection showed that SGLT2i use was associated with a lower risk of NTM infection (adjusted hazard ratio: 0.44, p &lt; 0.001), whereas male, age of 35 years or more, cancer and chronic airway diseases were associated with a higher risk of NTM infection. Diabetes complication tended to be associated with NTM infection only when the diabetes complications severity index (DCSI) was ≧ 3 ( p = 0.050).</div></div><div><h3>Conclusions</h3><div>SGLT2i use was less associated with NTM infection. In addition, adequate management of co-morbidities and good glycemic control to avoid complications were also associated with reduced risk of NTM infection.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 2","pages":"Article 103089"},"PeriodicalIF":4.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145733550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between early dexamethasone administration and mortality in SARS-CoV-2 infection: A cohort study","authors":"Renata Báez-Saldaña ,&nbsp;Ernesto Murillo-Trejo ,&nbsp;Lina Barranco-Garduño ,&nbsp;Juan Carlos Neri-Salvador ,&nbsp;Thalia Jacobo-Vargas ,&nbsp;Ana Laura Bazany-Rivero ,&nbsp;Uriel Rumbo-Nava","doi":"10.1016/j.jiph.2025.103066","DOIUrl":"10.1016/j.jiph.2025.103066","url":null,"abstract":"<div><h3>Background</h3><div>Dexamethasone, or equivalent corticosteroids, are recommended for patients with SARS-CoV-2 pneumonia, regardless of respiratory failure status. However, the effects of giving dexamethasone within the first seven days after symptom onset—during the viremic phase—have not been sufficiently studied in clinical trials or observational studies. As a result, the best timing for starting corticosteroids remains uncertain. This study aimed to evaluate the effect of dexamethasone administration within seven days of symptom onset from SARS-CoV-2 infection on mortality and the need for invasive mechanical ventilation among hospitalized patients with severe pneumonia.</div></div><div><h3>Methods</h3><div>This cohort study included hospitalized patients aged 18 years or older with severe SARS-CoV-2 pneumonia. The exposure was dexamethasone use before hospitalization, and the outcome measures included in-hospital mortality and invasive mechanical ventilation. Patients were monitored until discharge or death in the hospital. Logistic regression was used to evaluate the association between pre-hospitalization dexamethasone administration and mortality.</div></div><div><h3>Results</h3><div>We enrolled 234 patients. The median age was 56 years, and 70.5 % were men. Before hospitalization, dexamethasone was administered to 125 (53 %) patients within the first seven days of symptom onset, which was linked to mortality (OR [95 % CI] 3.58 [1.51–8.48]) and the need for invasive mechanical ventilation (OR [95 % CI] 2.59 [1.46–4.59]), after adjusting for factors such as, sex, Charlson comorbidity index ≥ 3, neutrophil count over 8500 cells/mm^³, and albumin below 3 g/dL.</div></div><div><h3>Conclusion</h3><div>Administering dexamethasone within the first seven days of SARS-CoV-2 infection may be associated with a higher risk of death in hospitalized patients with severe pneumonia. These findings emphasize the importance of carefully timing corticosteroid treatment in COVID-19 patients.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 2","pages":"Article 103066"},"PeriodicalIF":4.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145616030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"First documented outbreak of Bongkrekic acid food poisoning in Taiwan, March–April 2024","authors":"Andrei R. Akhmetzhanov ,&nbsp;Bianca de Padua ,&nbsp;Chung-Shun Wong ,&nbsp;Robin N. Thompson","doi":"10.1016/j.jiph.2025.103056","DOIUrl":"10.1016/j.jiph.2025.103056","url":null,"abstract":"<div><h3>Background</h3><div>Between March 19 and March 24, 2024, 33 people became ill after dining at a restaurant in Taipei, Taiwan. Nine were hospitalized, seven of whom were admitted to an intensive care unit (ICU). Six died as a result of the outbreak. The Bongkrekic acid (BA) toxin was identified as the cause of the food poisoning. For the first time in Taiwan, BA food poisoning was documented.</div></div><div><h3>Methods</h3><div>Using case data and restaurant consumption records, the daily attack rate (AR), case-fatality ratio (CFR) and time to seek healthcare were estimated. The estimated CFR was compared directly against CFRs reported in previous outbreaks.</div></div><div><h3>Results</h3><div>The AR varied from 43.8 % to 80.4 % during the outbreak (mean: 60.3 %). The mean estimate of the CFR was 20.0 %, with only one patient who was admitted to an intensive care unit surviving (out of seven). The CFR was higher than in past outbreaks in Indonesia (14.0 %) but lower than in China (39.5 %). The time to seek healthcare was shorter for hospitalized cases (mean 3.4 days) than non-hospitalized cases (mean 5.6 days).</div></div><div><h3>Conclusions</h3><div>The substantial AR and CFR, and poor outcomes for hospitalized cases, indicate that implementing rigorous food safety measures to prevent future outbreaks is crucial. Improved outbreak preparedness, including increasing public awareness and strengthening regulations relating to the production and storage of food products prone to BA contamination, are needed to prevent and mitigate the impacts of future BA poisoning events. This is essential for public health in Taiwan and elsewhere.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 2","pages":"Article 103056"},"PeriodicalIF":4.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145570765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Isolation, preliminary In Vitro screening, and In Vivo biosafety evaluation of a Siphoviridae bacteriophage against drug-resistant Salmonella Typhimurium","authors":"Abdulmalik B. Alowayyid ,&nbsp;Ahmed S. Alobaidi ,&nbsp;Shine Kadaikunnan ,&nbsp;Adel A. Abdulmanea ,&nbsp;Mohammed S. Alharbi ,&nbsp;Jamal M. Khaled","doi":"10.1016/j.jiph.2025.103063","DOIUrl":"10.1016/j.jiph.2025.103063","url":null,"abstract":"<div><h3>Background</h3><div>The increasing global threat of drug-resistant <em>Salmonella</em> Typhimurium has renewed interest in bacteriophage therapy as a viable alternative to conventional antibiotics.</div></div><div><h3>Methods</h3><div>This study aimed to isolate and investigate a specific bacteriophage that targets <em>Salmonella</em> Typhimurium ATCC 14028, and to evaluate its effects in rats. The bacterial strain was identified using the VITEK® 2 system, which also confirmed its reduced sensitivity to several standard antibiotics. The microscopic characteristics of the isolated bacteriophages were determined using transmission electron microscopy. Given the difficulty of inducing a Salmonella infection in rats or mice, the <em>In vivo</em> study evaluated the phage's effects on healthy, uninfected rats. The experiment involved a control, an antibiotic-treated group, and a bacteriophage-treated group. All treatments were delivered via intraperitoneal injection. Throughout the study, rats were monitored for behavioral changes, body weight, and histopathological and hematological parameters in the liver and spleen.</div></div><div><h3>Results</h3><div>A lytic bacteriophage was successfully isolated from untreated sewage, with <em>Salmonella</em> Typhimurium serving as the propagation host. Preliminary taxonomic classification, performed using transmission electron microscopy (TEM), suggested its affiliation with the <em>Siphoviridae</em> family. Furthermore, <em>In Vitro</em> assays provided evidence of the phage's robust lytic activity against the target bacterial strain. The hematological analysis of the group treated with the isolated bacteriophage revealed significant changes, including a decrease in red blood cell counts and hemoglobin levels, alongside notable shifts in leukocyte distribution compared to the control group. Histopathological examinations of the liver indicated mild hepatic steatosis and scattered inflammatory cell infiltration.</div></div><div><h3>Conclusions</h3><div>In conclusion, while the isolated <em>Siphoviridae</em> phage demonstrated potent <em>In vitro</em> activity against drug-resistant <em>Salmonella</em> Typhimurium strain, its administration to healthy rats induced measurable changes in both their blood profiles and tissue structures. These findings highlight the critical need for further safety and immunological studies before considering this phage for therapeutic use.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 2","pages":"Article 103063"},"PeriodicalIF":4.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145570763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inappropriate antibiotic prophylaxis before dental procedures in congenital heart disease: Insights from a nationwide Korean cohort","authors":"Soo In Jeong ,&nbsp;Hae-rim Kim ,&nbsp;Jin Young Song ,&nbsp;June Huh ,&nbsp;Hyun Joo Jung","doi":"10.1016/j.jiph.2025.103059","DOIUrl":"10.1016/j.jiph.2025.103059","url":null,"abstract":"<div><h3>Background</h3><div>The 2007 American Heart Association (AHA) guidelines strictly restrict antibiotic prophylaxis (AP) before dental procedures to patients at the highest risk of infective endocarditis (IE). However, national adherence to these guidelines in Korea, a country with high outpatient antibiotic use, remains unevaluated.</div></div><div><h3>Methods</h3><div>This population-based, retrospective cohort study using National Health Insurance Service System claims (2002–2022) included patients with atrial septal defect, ventricular septal defect, tetralogy of Fallot, or prosthetic cardiac valves. Dental claims within 14 days were clustered into one encounter. AP was defined as amoxicillin dispensed within 7 days (same day included) before the index visit, with an identical daily and single-dose IE prophylaxis regimen. Guideline adherence was assessed from January 1, 2008 onward (AP was appropriate only for invasive procedures performed during a high-risk period). Predictors of inappropriate AP were examined using multivariable logistic regression.</div></div><div><h3>Results</h3><div>Of 35,386 dental visits by 14,257 patients, 59.6 % were invasive procedures. AP was appropriate in 7491 visits (21.2 %) and inappropriate in 27,895 (78.8 %). Inappropriate prescriptions clustered in patients aged &lt; 20 years (76.1 %) and during moderate- (51.4 %) or low-risk periods (38.9 %). Inappropriate use decreased from 86.6 % in 2008–2012–72.9 % in 2018–2022. Independent predictors of inappropriate AP included age &lt; 5 years (adjusted odds ratio [aOR] 3.78) and 5–19 years (aOR 5.84); female sex (aOR 1.41); clinic setting (aOR 1.75 vs. tertiary hospitals); and pediatric dentistry (aOR 1.76) or pediatric prescriptions (aOR 1.21). Thoracic surgery providers were least likely to prescribe inappropriately (aOR 0.35).</div></div><div><h3>Conclusions</h3><div>A high proportion of dental AP prescriptions for Korean patients with CHD are still inappropriate according to the 2007 AHA guideline, particularly among pediatric populations and in primary-care clinics. Targeted stewardship—focused on pediatric dentists and clinic settings—is imperative to curb unnecessary antibiotic exposure while preserving prophylaxis for truly high-risk patients.</div></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":"19 2","pages":"Article 103059"},"PeriodicalIF":4.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145570769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}