The Korean government will phase in mandatory antibiotic stewardship programs (ASP) at general hospitals, requiring infectious disease specialists and pharmacists to continuously monitor antibiotic prescriptions. The measure aims to curb the spread of resistant bacteria by reducing antibiotic misuse.
The Korea Disease Control and Prevention Agency announced the "Third National Action Plan on Antimicrobial Resistance (2026-2030)" on Sunday in coordination with six other agencies, including the Ministry of Health and Welfare, the Ministry of Food and Drug Safety, the Ministry of Agriculture, Food and Rural Affairs, the Ministry of Climate, Energy and Environment, the Ministry of Oceans and Fisheries, and the Rural Development Administration. The plan centers on a "One Health" integrated approach spanning human, animal, food and environmental sectors.
The core strategy involves restructuring antibiotic use in healthcare facilities to "reduce and rationalize" prescriptions. Under ASP, teams of infectious disease specialists and dedicated pharmacists monitor antibiotic prescriptions and intervene when they are unnecessary or excessive. The government plans to implement ASP across all 170 general hospitals with 301 or more beds by 2027, followed by legislation in 2028 to institutionalize the system. Simultaneously, at least five regional leading hospitals will be designated to support ASP adoption at small and mid-sized hospitals. Antibiotic usage guidelines focusing on high-frequency diseases will also be developed and distributed for facilities lacking infection specialists.
The policy responds to a vicious cycle of high usage and high resistance rates. Korea's human antibiotic consumption reached 31.8 DID (defined daily doses per 1,000 inhabitants per day) in 2023, 1.6 times the OECD average of 19.5 DID. The resistance rate for MRSA (methicillin-resistant Staphylococcus aureus), a representative resistant bacterium, stood at 45.2% in 2023, far exceeding the global average of 27.1%. Notably, infections from CRE (carbapenem-resistant Enterobacterales), known as superbugs, surged from 5,717 cases in 2017 to 42,347 cases in 2024, increasing the burden on healthcare facilities.
Controls on the livestock and fisheries sectors will also be tightened. Antibiotic sales in the livestock sector reached 240 mg/PCU in 2024, significantly higher than the European average of 88.5 mg/PCU across 17 countries in 2023. By 2029, the government will adopt international standards for veterinary antibiotic usage indicators and overhaul prescription management by veterinarians and aquatic disease managers along with usage calculation systems. Environmental monitoring will also be expanded, including broader residue management under the Positive List System (PLS) and surveillance of resistant bacteria discharge in sewage treatment plants and rivers.
Technological responses will be strengthened as well. The government will support development of rapid diagnostic tests for resistant bacteria, new antibiotics and adjunctive therapeutics, while advancing research on AI and big data-based prescription optimization. "Based on interagency cooperation and public participation, we will gradually reduce antibiotic usage and resistance rates to manage the resistance problem and protect public health," the government said.