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Antibiotic therapy for inpatients with community‐acquired pneumonia in a developing country
Author(s) -
Trinh Hieu T.,
Hoang Phuong H.,
CardonaMorrell Magnolia,
Nguyen Hai T.,
Vu Dinh Hoa,
Dong Phuong T. X.,
Cao Thao T. B.,
Nguyen Son T.,
Pham Van T. T.,
Moss Le,
Dinh Kathryn,
Dartnell Jonathan,
Nguyen Huong T. L.
Publication year - 2015
Publication title -
pharmacoepidemiology and drug safety
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.023
H-Index - 96
eISSN - 1099-1557
pISSN - 1053-8569
DOI - 10.1002/pds.3614
Subject(s) - medicine , community acquired pneumonia , pneumonia , antibiotics , cephalosporin , medical prescription , medical record , combination therapy , intensive care medicine , microbiology and biotechnology , pharmacology , biology
Purpose The aim of this study was to identify antibiotic prescription patterns for community‐acquired pneumonia (CAP) in Vietnam. Methods Medical records for CAP adult patients admitted to 10 hospitals across the country were randomly selected from admission lists during the peak pneumonia season. CAP cases were identified from manual record reviews by clinical pharmacists. Data was collected using a standard data collection tool including patient clinical features on admission, comorbidities, microbiological culture results, and antibiotic regimens. Pneumonia severity was estimated using the CURB‐65 score. Results A total of 649 medical records for adult patients (55.2% male and 52.3% urban residents, median age 68 years) met the selection criteria for CAP. Pneumonia severity was assessed as mild (64.1% of patients), moderate (23.0%), and severe (9.2%). Antibiotics were most frequently administered intravenously (93.4%) and as combination therapy (dual therapy 54.4%, monotherapy 42.5%, and triple therapy 3.1% of patients) regardless of CAP severity. Third‐generation cephalosporins were used most frequently (29.3% as monotherapy and 40.4% as combination therapy). Third‐generation cephalosporins were most commonly combined with penicillins and/or quinolones. Conclusions This first nationwide study provides a baseline profile of antibiotic use in the treatment of CAP. Third‐generation cephalosporins were widely used for initial empirical management of CAP, often in combination with quinolones, regardless of CAP severity. The study will assist in providing an evidence base to inform new national antibiotic guidelines for CAP management and will contribute locally relevant data for the national master plan addressing antibiotic resistance and the development of educational interventions to improve CAP management. Copyright © 2014 John Wiley & Sons, Ltd.