Antibiotic use for empirical therapy in the critical care units in primary and secondary hospitals in Vietnam: a multicenter cross-sectional study.

Autor:	Dat VQ; Department of Infectious Diseases, Hanoi Medical University, Hanoi, Vietnam (No 1 Ton That Tung street, Dong Da district, Hanoi, Vietnam).; Hanoi Medical University Hospital, Hanoi Medical University, Hanoi, Vietnam (No 1 Ton That Tung street, Dong Da district, Hanoi, Vietnam)., Dat TT; Department of Infectious Diseases, Hanoi Medical University, Hanoi, Vietnam (No 1 Ton That Tung street, Dong Da district, Hanoi, Vietnam)., Hieu VQ; Hanoi Medical University Hospital, Hanoi Medical University, Hanoi, Vietnam (No 1 Ton That Tung street, Dong Da district, Hanoi, Vietnam)., Giang KB; Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam (No 1 Ton That Tung street, Dong Da district, Hanoi, Vietnam)., Otsu S; World Health Organisation Viet Nam Country Office, Hanoi, VietNam (304 Kim Ma Street, Hanoi, VietNam).; Infectious Disease Department, Japanese Red Cross Wakayama Medical Centre, Wakayama City, Wakayama, Japan (4-20 Komatsubara-dori, Wakayama City 640-8558, Wakayama, Japan).
Jazyk:	angličtina
Zdroj:	The Lancet regional health. Western Pacific [Lancet Reg Health West Pac] 2021 Nov 03; Vol. 18, pp. 100306. Date of Electronic Publication: 2021 Nov 03 (Print Publication: 2022).
DOI:	10.1016/j.lanwpc.2021.100306
Abstrakt:	Background: The high rate of infections among patients admitted to critical care units (CCUs) is associated with high rate of antibiotic consumption, especially broad-spectrum antibiotics. This study is to describe the antibiotics use in CCUs in primary and secondary hospitals in Vietnam, a setting with high burden of antibiotic resistance. Methods: This was a 7-day observational study in 51 CCUs in hospitals from 5 provinces in Vietnam from March to July 2019. Patients aged ≥ 18 years admitted to the participating CCUs was enrolled consecutively. We collected data on patient's demographics, initial diagnosis and antibiotic therapy within the first 24 hours. Antibiotic therapy was classified by the Anatomical Therapeutic Chemical (ATC) Index and the 2019 WHO Access, Watch, Reserve (AWaRe) groups. Findings: Out of 1747 enrolled patients, empirical antibiotic treatments were initiated in 1112 (63.6%) patients. The most frequently prescribed antibiotics were cefotaxime (22.3%), levofloxacin (19%) and ceftazidime (10.8%). Antibiotics were given in 31.5% of patients without diagnosis of infection. Watch and/or Reserve group antibiotic were given in 87.3% of patients and associated with patient's age (aOR 1.01 per 1-year increment, 95%CI 1.00-1.02) and the presence of SIRS on admission (aOR 2.1, 95%CI 1.38-3.2). Interpretation: We observed a high frequency use and a substantial variation in patterns of empirical antibiotic use in the CCUs in Vietnam. It highlights the importance of continuous monitoring antibiotic consumption in CCUs. Competing Interests: We declare no competing interest. (© 2021 The Authors.)
Databáze:	MEDLINE
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