Changes in Antimicrobial Prescriptions in South Korea during and beyond the Coronavirus Disease 2019 Pandemic: An Interrupted Time-Series Analysis.

Am J Infect Control

Department of Physiology, Dong-A University College of Medicine, Busan, Republic of Korea; Department of Data Sciences Convergence, Dong-A University, Busan, Republic of Korea. Electronic address:

Published: August 2025


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Article Abstract

Background: Although the coronavirus pandemic significantly affected antibiotic use, studies on the long-term effects of the pandemic on antibiotic use are lacking. We aimed to investigate the changes in antibiotic prescriptions during the pandemic and subsequent endemic period in South Korea.

Methods: For this interrupted time-series study, we used claims data from the National Health Insurance System for January 2018 to December 2023. We used generalized least-squares models with the pandemic and endemic periods as interventions. We measured changes in the number of patients prescribed antibiotics, number of prescriptions, and cost of prescriptions during the pre-pandemic, pandemic, and endemic periods. Subgroup analyses were conducted according to hospital type, patient type, and antibiotic class.

Results: During the study period, 694 million patients were prescribed antibiotics. The standardized coefficient of immediate effect on the number of patients prescribed antibiotics at the start of the pandemic was -0·936 (p<·001). Abrupt decreases were followed by a gradual upslope during the endemic (0·577, p<·001). Tertiary hospitals exhibited an immediate decrease at the beginning of the pandemic (-0·869, p<·001) and early subsequent recovery during the endemic (1·491, p=·001).

Conclusions: This study may help inform flexible policies for infection control, antimicrobial stewardship, and public health improvement.

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http://dx.doi.org/10.1016/j.ajic.2025.08.021DOI Listing

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