[Grades of Antibiotic Prescription Rates for Acute Upper and Lower Respiratory Tract Infections in the Republic of Korea in 2023 and Trends in Grade Changes from 2020 to 2023].

Objectives: In this study, we aimed to promote the appropriate use of antibiotics by analyzing antibiotic prescription rate grades for acute upper respiratory tract infections (URTIs) and lower respiratory tract infections (LRTIs) across healthcare institutions in the Republic of Korea. We also examined variations by institution type and region. Methods: This study used data from the pharmaceutical benefit appropriateness evaluation published on the Health Insurance Review and Assessment Service website in 2023. Antibiotic prescription rate grades (Grades 1-5 and grade-exempt institutions) were analyzed according to healthcare institution type and region for acute URTIs and LRTIs. Additionally, changes in the prescription rate grades from 2020 to 2023 were compared. Results: In 2023, the overall proportion of Grades 1-5 among medical institutions was higher for acute LRTIs (65.0%) than for URTIs (55.8%). Tertiary hospitals had the highest proportion of Grade 1 levels for both infection types-94.7% for URTIs and 97.6% for LRTIs-and consistently maintained high grade levels (Grades 1 and 2) from 2020 to 2023. In contrast, clinics showed the highest proportion of lower grades (Grades 4 and 5) in 2023. Although regional variations among clinics was relatively small, the proportion of lower grades remained consistently high across regions. Conclusions: Antibiotic prescription grade distribution varied significantly according to the type of healthcare institution and region. Clinics, in particular, showed a need for improvement in antibiotic prescribing practices. Therefore, establishing tailored strategies that reflect the characteristics of infection and institution types and regions is necessary to promote the appropriate use of antibiotics. To this end, educational programs and guidelines that consider the varying levels of awareness regarding antibiotic use are essential.