Antibiotics Prescribed for 13% of Simple Influenza Cases Without Complications... ENT Three Times Higher Than Other Specialties

Analysis of Medication Prescriptions for Influenza Patients

Gastrointestinal Agents Prescribed in 8 out of 10 Influenza Cases

NHIS: "Revision of Reimbursement Standards Needed for Medication Prescriptions"

It has been found that antibiotics were prescribed in more than 1 out of 10 cases even for simple influenza treatment without complications. The National Health Insurance Service (NHIS) has defined this as overprescription and suggested the need to revise reimbursement standards.

On June 11, the NHIS announced that it had analyzed the prescription status of antibiotics and gastrointestinal agents for approximately 1.4 million adult patients diagnosed with influenza at clinics from July 2023 to June 2024.

The analysis showed that in 13.3% of low-risk episodes (simple influenza cases without complications, totaling 256,823 cases), antibiotics were prescribed despite a low necessity for such medication. These low-risk episodes accounted for 18.3% of all influenza treatments. The NHIS considered this as a case of antibiotic overuse.

It was also found that prescribing antibiotics tended to increase the duration of treatment. Episodes in which antibiotics were prescribed had an average treatment period about 13% longer than those without, a difference that was statistically significant according to the NHIS. By age group, compared to patients aged 18 to under 40, the treatment period was 13% longer for those aged 40 to under 65, 24% longer for those aged 65 to under 75, and 29% longer for those aged 75 and older, indicating that older patients took more time to recover.

An analysis of institutional characteristics influencing antibiotic prescriptions for low-risk episodes identified medical specialty and physician age as key factors. The odds ratio (OR) for prescribing antibiotics in low-risk episodes was highest in otorhinolaryngology at 3.08 times that of other specialties, followed by general practice (about 1.65 times) and pediatrics (about 1.53 times). In contrast, internal medicine showed the lowest odds at about 0.69 times. By physician age, those aged 65 and older were about 2.03 times more likely to prescribe antibiotics compared to those under 45, and those aged 55 to under 65 had an odds ratio of about 1.34.

The prescription rate for gastrointestinal agents averaged 77.2% (median 91.4%), indicating a prevalent pattern of routine co-prescription of such medications during influenza treatment was observed in this analysis.

Prescription patterns also differed by medical specialty and physician age. The rate of antibiotic prescription was lowest in internal medicine (19.0%) but higher in pediatrics (37.5%) and otorhinolaryngology (32.4%). For gastrointestinal agents, otorhinolaryngology had the highest rate (84.6%), while pediatrics was lower (62.9%). By physician age, the antibiotic prescription rate was lower among those under 45 (23.3%) and higher among those 65 and older (33.2%). In contrast, the prescription rate for gastrointestinal agents was highest among those under 45 (83.9%).

Experts emphasized the importance of appropriate treatment, noting that healthcare providers sometimes prescribe antibiotics and gastrointestinal agents defensively for the sake of patients. Park Youngmin, professor of family medicine at Ilsan Hospital, stated, "Preemptive antibiotic prescription at the stage of simple influenza without complications offers little practical benefit in shortening the overall treatment period," adding, "Joint efforts by the medical community and the public are needed to reduce medication misuse."

An NHIS official said, "There is a need to revise reimbursement standards regarding antibiotic prescriptions for uncomplicated influenza and the habitual prescription of gastrointestinal agents," adding, "It is also the insurer's important role to ensure that people do not suffer health problems due to unnecessary medication."

This content was produced with the assistance of AI translation services.