Korean doctors’ prescription rate of antibiotics to treat colds plunged to 35 percent in 2021 from 73 percent in 2002, according to a report released Friday by the Health Insurance Review and Assessment Service (HIRA).

Tertiary general hospitals’ antibiotics prescription rate for a cold remained at a mere 6 percent, the report said.

The state-run health insurance screening agency evaluated medication benefit adequacy of 52,240 medical and healthy institutions nationwide from January to December last year based on outpatient treatment details, the review of which has been completed.

According to the result, the antibiotic prescription rate for acute upper respiratory infections, including colds, stood at 35.14 percent in 2021, down by 38.1 percentage points from 73.33 percent in 2002. The rate was lowest at tertiary general hospitals with 6.10 percent, followed by 24.75 percent at general hospitals, 34.49 percent at hospitals, and 44.95 percent at clinics.

The antibiotic prescription rate for acute lower respiratory infections, including acute bronchitis, remained at 56.95 percent, a drop of 3.85 percentage points from 60.80 percent in 2016. The comparable rates for the four categories of medical facilities by size were 13.11 percent, 38.04 percent, 51.35 percent, and 57.92 percent, maintaining a trend of the rate’s going up as hospital sizes go down.

Viruses mostly cause acute upper respiratory inspections and acute lower respiratory infections, and antibiotics are not recommended.

The injection rate was 12.08 percent, down 26.52 percentage points from 38.62 percent in 2002. Tertiary general hospitals showed the lowest rate of 1.23 percent, followed by general hospitals’ 5.32 percent, hospitals’ 12.29 percent, and neighborhood clinics’ 13.93 percent.

HIRA has conducted medication benefit adequacy evaluations and made public results since 2001. Major assessment items are antibiotic prescription rate, injection rate, and the number of medicines per prescription.

The agency said it would expand its evaluation from next year to manage antibiotic resistance better and strengthen patient safety. It will add new assessment items, such as the volume of antibiotics used to treat respiratory diseases and prescription rates for the elderly.

Starting next year, Korea will also introduce DDD (Defined Daily Dose) of antibiotics, used in the OECD and the U.K., as an evaluation index. DDD measures the amount of medicine, an average daily maintenance dose for adults weighing 70 kg.

According to HIRA, Korea’s antibiotic prescription rate in 2019 was 23.7 DID, higher than the OECD average of 17.0 DID. DID (Dose for Inhabitant per Day) refers to defined doses of antibiotics for 1,000 people daily.

“Overall, the index results improved in 2021. However, the antibiotic prescription rate for acute lower respiratory infections remained high, and the progress in the acute upper respiratory prescription rate was also slow at hospital-level institutions,” said Chung Young-ae, head of the HIRA’s Assessment Office. “We will seek to provide more incentives for these hospitals while offering various supports, including consulting and PR activities, for low-graded institutions.”