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M 24: Evaluation of the Appropriateness of Mupirocin Prescription in the Ambulatory Setting
Chung-Ang University Korea, Republic of
The objective of this study was to investigate the prescription patterns of mupirocin, which is known to be highly correlated with antimicrobial resistance and to evaluate its appropriateness of prescription in the ambulatory setting.
The 2010-2012 Health Insurance and Review and Assessment service-National Patient Sample dataset of South Korea was used to analyze mupirocin prescription patterns. The National Ambulatory Medical Care Survey dataset was used to quantify mupirocin prescription in the United States for comparison.
Author: JinUk Suh
Co-authors: SeungYeon Song, MyungSuk Yang, Hyunjun Shim, JiHee Yun, Eunyoung Kim
Department of Pharmaceutical Industry Management, Graduate School, Chung-Ang University, Seoul, South Korea
Department of Health, Social and Clinical Pharmacy, College of Pharmacy, Chung-Ang University, Seoul, South Korea
To assess the mupirocin prescription patterns, the number of prescriptions, the mean duration of prescribed use, the rate of prescriptions for over 10 day-duration and the rate of repeat prescription within 30 days as well as the diagnostic codes were analyzed. In the ambulatory setting, the annual prescription number for mupirocin was 4,683 (95% Confidence Interval, CI [4,661-4,703]) per 100,000 population, the mean duration of prescribed use was 1.14 days (± Standard Deviation, SD 0.001904), the rate of prescriptions for use over 10 days was 0.03% (95% CI [0.018-0.03]) and the rate of repeat prescription within 30 days was 8% (95% CI [7.92-8.18]). The most frequently used diagnostic code was “Viral wart” followed by “Corns and callosities”, “Molluscum contagiosum” and “Local infection of skin and subcutanouse tissue, unspecified”. Using the National Ambulatory Medical Care Survey data of the United States, annual mupirocin prescription rate was calculated to be 1,148 (95% CI [975-1,320]) per 100,000 population which is nearly a quarter of the rate in South Korea.
This study is first to investigate the patterns of mupirocin prescription in the ambulatory setting. Most of the duration of use prescribed was short with an average of one day and prescriptions for over 10 day use was rare. The rate of repeat prescription within 30 days, however, was almost relatively frequent which shows that further studies are required to investigate the rationale behind prescribing mupirocin again. The prescription amount of mupirocin in South Korea is four times greater than that in the United States and as mupirocin is an Over-The-Counter drug in South Korea and an Ethical drug in the United States, real amount of mupirocin usage could be much higher in South Korea. Most of the diagnostic codes for mupirocin use was related to surgical procedures which implies that mupirocin was inappropriately used to prevent infection rather than as a treatment. Such inappropriate and excessive use of mupirocin can increase antimicrobial resistance development. Although use of mupirocin poses a high risk to the global issue of antimicrobial resistance, only a limited number of studies has been conducted in the ambulatory setting. We believe that our study findings will provide a valuable future resource for researchers in conducting further analyses and antibiotic resistance studies.