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South Korea’s health care system is praised for its speed and accessibility, but the resulting ease at which patients receive antibiotics is leading to a rise in antibiotic-resistant “superbugs.”
According to the Korea Disease Control and Prevention Agency, South Korea recorded 31.8 defined daily doses, or DID, of antibiotics per 1,000 people in 2023, placing it second among the 34 member countries of the Organization for Economic Cooperation and Development, behind Turkey.
This is its highest rate on record, and marks a sharp rise from last year’s 27.3, the previous record, and the pandemic low of 16 in 2021, when Korea ranked sixth. The OECD average stands at just 18.3 DID, highlighting the chronic overuse of antibiotics in the country.
Antibiotics — medications that kill or inhibit the growth of bacteria — revolutionized modern medicine after Alexander Fleming discovered penicillin in 1928.
They were first introduced in Korea after liberation from Japanese occupation, arriving in earnest during the 1950-53 Korean War. Penicillin became so valuable during wartime that it was traded on black markets and hoarded by military officers.
However, what were once considered miracle drugs have become a double-edged sword. Repeated and unnecessary exposure to antibiotics has led to the emergence of resistant strains of bacteria that no longer respond to conventional treatments. The phenomenon of antibiotic resistance makes common infections harder, and sometimes impossible, to treat.
Misuse in daily life
In South Korea, the overuse of antibiotics has been rooted in decades of medical practice. Until the early 2000s, antibiotics were routinely given to treat common colds and viral infections, despite the fact that antibiotics are not effective against viruses.
Historically, many clinics prescribed antibiotics preemptively, often to meet patient expectations or to shorten consultation times. Combined with lax oversight at pharmacies and limited public education, this culture of “just in case” medicine has led to widespread misuse.
“People often take antibiotics ‘just in case’ to prevent a minor illness from worsening. But this practice is dangerous,” said infectious disease specialist Dr. Song Jang-wook of Korea University Anam Hospital.
Lawmakers have also raised alarm. During a recent parliamentary audit, Rep. Choi Bo-yoon of the ruling People Power Party pointed out that infections caused by carbapenem-resistant Enterobacteriaceae, or so-called “superbugs,” surged to over 40,000 cases in 2024, more than seven times the number of cases seven years ago.
“These multidrug-resistant bacteria are nearly impossible to treat and pose a severe threat to national health,” Choi said. “Their growth indicates that antibiotic overuse remains unchecked and that our monitoring systems are failing.”
Since 2019, the World Health Organization has designated antibiotic resistance as one of the top 10 public health threats facing humanity.
According to the KDCA, the misuse and overuse of antibiotics are linked to longer hospital stays, rising medical costs, and a higher risk of severe or fatal outcomes in vulnerable groups such as older adults, infants and people with weakened immune systems.
Stopping the rot
Public health experts stress that, unlike many other medical crises, antibiotic resistance is entirely preventable, with active participation from society as a whole.
The KDCA highlights three fundamental principles the public must follow to curb the spread of resistant bacteria.
1. Antibiotics should be taken only when prescribed by a qualified health care professional.
2. Patients must complete the full prescribed course, even if symptoms improve early.
3. Under no circumstances should people share leftover pills or self‑medicate.
The agency is also urging health care professionals to take an active role in stemming the crisis.
Doctors are encouraged to adopt more responsible, evidence‑based prescribing practices and to communicate clearly with patients about when antibiotics are unnecessary.
Transparent conversation, the KDCA says, is essential for rebuilding public trust and reducing the expectation of receiving antibiotics at every clinic visit.
Acknowledging the seriousness of the issue, Health and Welfare Minister Jeong Eun-kyung said she fully recognized the gravity of antibiotic resistance.
“We are working on a comprehensive, cross-ministerial action plan to address the issue and will improve coordination between agencies,” Jeong said.
Jeong also addressed delays in adopting antifungal and antiviral drugs, saying the ministry would consider waiving economic evaluations for new treatments to accelerate their availability.
“The most important aspect of resistance prevention is appropriate use,” she said. “We are piloting antibiotic stewardship programs in hospitals and plan to expand them nationwide.”
Marking World Antimicrobial Awareness Week from Nov. 18-24, KDCA Commissioner Lim Seung-kwan warned that antibiotic resistance is not a distant threat.
“It is a serious public health issue that links humans, animals and the environment,” he said. “As Korea’s health authority, we will protect the public from this threat and build a safer society.”
Nine things to know about antibiotics
1. Antibiotics treat bacterial infections, not viruses.
2. Overuse causes resistance and reduces effectiveness
3. Resistance is now a global crisis
4. Resistant infections increase death rates and economic losses.
5. Misuse is also rampant in agriculture and aquaculture
6. Responsible use is the first step toward prevention
7. Antibiotics must only be taken with proper medical guidance.
8. Once prescribed, they must be taken fully and properly
9. Resistance crosses borders — international cooperation is vital
jychoi@heraldcorp.com