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越南门诊患者抗生素的合理使用及相关因素

Appropriate Antibiotic Use and Associated Factors in Vietnamese Outpatients.

作者信息

Nguyen Lam V, Pham Lien T T, Bui Anh L, Vi Mai T, Nguyen Nguyet K, Le Tam T, Pham Suol T, Nguyen Phuong M, Nguyen Thao H, Taxis Katja, Nguyen Thang, Tran Hung D

机构信息

Department of Anatomy, Can Tho University of Medicine and Pharmacy, Can Tho City 900000, Vietnam.

Department of Medicinal Chemistry, Can Tho University of Medicine and Pharmacy, Can Tho 900000, Vietnam.

出版信息

Healthcare (Basel). 2021 Jun 8;9(6):693. doi: 10.3390/healthcare9060693.

Abstract

: Inappropriate antibiotic use among outpatients is recognized as the primary driver of antibiotic resistance. A proper understanding of appropriate antibiotic usage and associated factors helps to determine and limit inappropriateness. We aimed to identify the rate of appropriate use of antibiotics and identify factors associated with the inappropriate prescriptions. : We conducted a cross-sectional descriptive study in outpatient antibiotic use at a hospital in Can Tho City, Vietnam, from August 1, 2019, to January 31, 2020. Data were extracted from all outpatient prescriptions at the Medical Examination Department and analyzed by SPSS 18 and Chi-squared tests, with 95% confidence intervals. The rationale for antibiotic use was evaluated through antibiotic selection, dose, dosing frequency, dosing time, interactions between antibiotics and other drugs, and general appropriate usage. : A total of 420 prescriptions were 51.7% for females, 61.7% with health insurance, and 44.0% for patients with one comorbid condition. The general appropriate antibiotic usage rate was 86.7%. Prescriptions showed that 11.0% and 9.5% had a higher dosing frequency and dose than recommended, respectively; 10.2% had an inappropriate dosing time; 3.1% had drug interactions; and only 1.7% had been prescribed inappropriate antibiotics. The risk of inappropriate antibiotic use increased in patients with comorbidities and antibiotic treatment lasting >7 days ( < 0.05). : The study indicated a need for more consideration when prescribing antibiotics to patients with comorbidities or using more than 7 days of treatment.

摘要

门诊患者抗生素使用不当被认为是抗生素耐药性的主要驱动因素。正确理解适当的抗生素使用方法及相关因素有助于确定并限制不当使用情况。我们旨在确定抗生素的适当使用率,并找出与不当处方相关的因素。

我们于2019年8月1日至2020年1月31日在越南芹苴市一家医院开展了一项关于门诊抗生素使用的横断面描述性研究。数据从体检科的所有门诊处方中提取,并通过SPSS 18软件和卡方检验进行分析,置信区间为95%。通过抗生素选择、剂量、给药频率、给药时间、抗生素与其他药物之间的相互作用以及一般适当用法来评估抗生素使用的合理性。

总共420份处方中,女性占51.7%,有医疗保险的占61.7%,患有一种合并症的患者占44.0%。抗生素总体适当使用率为86.7%。处方显示,给药频率和剂量高于推荐值的分别占11.0%和9.5%;给药时间不当的占10.2%;存在药物相互作用的占3.1%;而开具不当抗生素的仅占1.7%。合并症患者以及抗生素治疗持续超过7天的患者出现抗生素使用不当的风险增加(<0.05)。

该研究表明,在给合并症患者开抗生素处方或进行超过7天的治疗时,需要更多考虑。

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J Antimicrob Chemother. 2019 Feb 1;74(2):515-520. doi: 10.1093/jac/dky447.

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