title: Dramatic decrease in fluoroquinolones in the pediatric population in Korea.
abstract: OBJECTIVE
  This study was performed to evaluate the change of prescribing patterns after the regulatory action regarding fluoroquinolones in pediatric patients.
  
  
  METHODS
  We conducted a time series analysis using the Korea Health Insurance Review and Assessment Service National Patients Sample database. Study subjects consisted of pediatric patients under 18 years of age who were prescribed antibiotics at least once (ATC code, J01) before (January 2009-December 2009) and after implementation (January 2010-December 2011) of the regulation. The use of fluoroquinolones was defined as the use of the following antibiotics for at least once in pediatric patients: ofloxacin, ciprofloxacin, norfloxacin, lomefloxacin, levofloxacin, and gemifloxacin. We calculated the number of pediatric fluoroquinolone users for each month. The difference between proportions before and after the regulation was estimated as relative and absolute reduction of fluoroquinolone use. We calculated 95% confidence intervals (CI).
  
  
  RESULTS
  We identified 4, 945, 169 antibiotic prescriptions in 484, 914 pediatric patients. During the 12-month period before implementation, percentage of fluoroquinolone use was 4.81% (95% CI: 4.70-4.91%, N = 8001). We observed a rapid decrease in the monthly number of fluoroquinolone users in pediatric population after the implementation of regulatory action. In the year after regulatory action, the percentage of fluoroquinolone use was only 0.26% (95% CI: 0.24-0.28%, N = 834). Overall, there was a 94.55% relative reduction (95% CI: 88.02-101.56%) in the use of fluoroquinolones.
  
  
  CONCLUSIONS
  Korean regulatory actions regarding fluoroquinolones had an effect of reducing use in pediatric population.
authors.affiliation: Korea Institute of Drug Safety and Risk Management (KIDS), Seoul, Korea.
authors.forename: Ju-Young
authors.initials: JY
authors.lastname: Shin
authors.forename: Mi Hee
authors.initials: MH
authors.lastname: Kim
authors.forename: Sun Mi
authors.initials: SM
authors.lastname: Shin
authors.forename: Shin Haeng
authors.initials: SH
authors.lastname: Lee
authors.forename: Byung-Joo
authors.initials: BJ
authors.lastname: Park
mesh_terms: D000293:Adolescent; D000890:Anti-Infective Agents; D002648:Child; D002675:Child, Preschool; D005260:Female; D024841:Fluoroquinolones; D006801:Humans; D008297:Male; D010818:Practice Patterns, Physicians' / Q000331:legislation & jurisprudence / Q000592:standards / Q000639:trends*; D056910:Republic of Korea
chemical_list: D000890:Anti-Infective Agents; D024841:Fluoroquinolones
keywords: drug utilization review; fluoroquinolone; pediatrics; pharmacoepidemiology; regulatory action