항생제 사용량 감소 및 내성 관리를 위한 현황 분석 및 정책 개발 연구(치료적 항생제 중심으로)
- Type
- Research report
- Issued Date
- 2025-01
- Keyword
- 항생제; 항생제 스튜어드십; 국가 항생제; 내성 관리대책; 약제급여 적정성 평가
- Publisher
- 건강보험심사평가원
- Table Of Contents
- 요약 ···························································································· ⅰ
제1장 서론 1
1. 연구 배경 ······························································································ 3
2. 연구 목적 ······························································································ 7
3. 연구 내용 및 방법 ·················································································· 7
제2장 국내외 항생제 관리 정책 9
1. 항생제 관리 전략의 국제적 흐름 ···························································· 11
가. Global Action Plan ················································································· 11
나. One Health 프레임워크 ··········································································· 14
다. 항생제 스튜어드십 프로그램(ASP: Antimicrobial Stewardship Program) ···· 16
라. WHO의 AWaRe 개념 및 분류 ································································· 19
2. 국내 항생제 관리 정책 및 제도 ····························································· 23
가. 국가 항생제 관리 정책 ·············································································· 23
나. 항생제 사용량 관리를 위한 건강보험 제도 ·················································· 26
다. 의료기관 인증제도 ···················································································· 37
라. 항생제 스튜어드십 활동 지원 ····································································· 40
마. 교육 및 홍보 ··························································································· 43
3. 국외 항생제 관리 정책 및 제도 ····························································· 44
가. 미국 ········································································································ 45
나. 영국 ········································································································ 66
다. 호주 ········································································································ 83
라. 일본 ········································································································ 94
4. 소결 및 시사점 ·················································································· 112
제3장 항생제 사용 현황 분석 121
1. 개요 ·································································································· 123
가. 분석 개요 ······························································································ 123
나. 분석 자료 ······························································································ 124
2. 전체 항생제 사용 현황 분석 ································································ 126
가. 분석 개요 ······························································································ 126
나. 분석 내용 및 방법 ·················································································· 126
다. 연도별 항생제 사용 현황 ········································································· 130
3. 입원/외래 항생제 사용 현황 분석 ························································· 146
가. 분석 개요 ······························································································ 146
나. 분석 내용 및 방법 ·················································································· 146
다. 입원 항생제 사용 현황 ············································································ 150
라. 외래 항생제 사용 현황 ············································································ 170
마. 의원급 외래 추가 분석 ············································································ 193
4. 질환별 항생제 사용 현황 ····································································· 215
가. 분석 개요 ······························································································ 215
나. 분석 내용 및 방법 ·················································································· 215
다. 질환별 항생제 사용 지침 ········································································· 223
라. 질환별 분석 결과 ···················································································· 231
5. 소결 및 시사점 ·················································································· 278
가. 전체 항생제 사용량 규모 및 증가 추이 ··················································· 278
나. 입원 항생제 사용 현황 ············································································ 282
다. 외래 항생제 사용 현황 ············································································ 283
라. 질환별 항생제 사용 현황 ········································································· 288
제4장 항생제 사용 관리를 위한 정책 제안 295
1. 정책 방안 도출을 위한 고찰 ································································ 297
가. 약제급여 적정성 평가 ·············································································· 299
나. 항생제 스튜어드십 활동 ··········································································· 309
다. 국민 및 의료진의 항생제 인식 개선 ·························································· 314
라. 국내외 협력체계 강화 ·············································································· 315
2. 정책 제안 ·························································································· 316
가. 약제급여 적정성 평가 지표 개선 및 인센티브 강화 ···································· 318
나. 스튜어드십 활동 지원 강화 ······································································ 322
다. 교육·홍보 자료 및 지침 개발 확대와 활용도 증대 ······································ 324
라. 항생제 사용 관리를 위한 국내외 협력체계 강화 ········································· 326
제5장 결론 329
1. 연구의 의의 및 한계 ··········································································· 331
2. 결론 ·································································································· 333
◾ 참고 문헌 ····················································································· 335
◾ 부록 ····························································································· 343
◾ ABSTRACT ················································································· 399
- Publisher
- 건강보험심사평가원
- Location
- KOR
- Citation
- 김유정. (2025-01). 항생제 사용량 감소 및 내성 관리를 위한 현황 분석 및 정책 개발 연구(치료적 항생제 중심으로).
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