Antimicrobial Stewardship Program at a tertiary teaching hospital in Vietnam: A longitudinal observational study

Sơn, Nguyễn Trường; Tra, Ton Thanh; Thao, Pham Thi Ngoc

doi:10.15761/cmid.1000121

Cited by 3 publications

(4 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This result was in contrast to the study by Eva Polverino et al 2013 [18] conducted in Spain, a country with low rate of AMR. This difference could be associated with distinct characteristics of the respiratory department of Cho Ray hospital, a central tertiary hospital with severe patients (frequent hospitalization), admitting patients who were treated antibiotics at grassroots hospitals without improvement, overloaded status, and the high rate of AMR [19]. This also implies that the concept of HCAP at our hospital could be separated clearly with CAP but undifferentiated with HAP.…”

Section: Discussionmentioning

confidence: 91%

Healthcare associated pneumonia: An old concept at a hospital with high prevalence of antimicrobial resistance

Nguyen-Ho¹,

Hoang-Thai²,

Vu³

et al. 2021

MedPharmRes

View full text Add to dashboard Cite

Background: One of several reasons that the concept of healthcare-associated pneumonia (HCAP) was dismissed was the same presence of multidrug resistant organism (MDRO) between community-acquired pneumonia and HCAP at countries with the low prevalence of antimicrobial resistance (AMR). However, this finding could be unsuitable for countries with the high rates of AMR. Methods: A prospective observational study was conducted at the respiratory department of Cho Ray hospital from September 2015 to April 2016. All adult patients suitable for community acquired pneumonia (CAP) with risk factor for healthcare-associated infection were included. Results: We found out 130 subjects. The median age was 71 years (interquartile range 57-81). The male/female ratio was 1.55:1. Prior hospitalization was the most common risk factor for healthcare-associated infection. There were 35 cases (26.9%) with culture-positive (sputum and/or bronchial lavage). Isolated bacteria included Pseudomonas aeruginosa (9 cases), Klebsiella pneumoniae (9 cases), Escherichia coli (4 cases), Acinetobacter baumannii (6 cases), and Staphylococcus aureus (7 cases) with the characteristic of AMR similar to the bacterial spectrum associated with hospital-acquired pneumonia. Conclusion: MDROs were detected frequently in CAP patients with risk factor for healthcare-associated infection at the hospital with the high prevalence of AMR. This requires the urgent need to evaluate risk factors for MDRO infection in community-onset pneumonia when the concept of HCAP is no longer used.

show abstract

Section: Discussionmentioning

confidence: 91%

Healthcare associated pneumonia: An old concept at a hospital with high prevalence of antimicrobial resistance

Nguyen-Ho¹,

Hoang-Thai²,

Vu³

et al. 2021

MedPharmRes

View full text Add to dashboard Cite

show abstract

“…Cho Ray Hospital, a national-level hospital located in HCMC, has also established its own AMS program, which includes antibiotic use monitoring and especially for surgical patients in which prophylactic antibiotics are frequently inappropriately given [ 32 , 73 ]. The hospital’s guidance on antibiotic use has been updated frequently, with internal training for healthcare staff based upon these guidelines.…”

Section: Resultsmentioning

confidence: 99%

“…The hospital’s guidance on antibiotic use has been updated frequently, with internal training for healthcare staff based upon these guidelines. Compliance with these guidelines increased by approximately 15% in 2017 compared to that in 2015 [ 32 ].…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Health system barriers to the implementation of the national action plan to combat antimicrobial resistance in Vietnam: a scoping review

Pham,

Dang,

Nguyen

et al. 2024

Antimicrob Resist Infect Control

View full text Add to dashboard Cite

Background Vietnam is among 11 countries in the Western Pacific region that has developed a National Action Plan for Antimicrobial Resistance (NAPCA). Methods This scoping review characterises health system barriers to the implementation of the Vietnam NAPCA, with reference to the WHO Health Systems Framework. Results Over 7 years, between 2013 and 2020, the Ministry of Health (MOH) of Vietnam has been implementing activities to achieve the six NAPCA objectives. They include revision of regulations needed for antimicrobial resistance (AMR) prevention programs; formation and operation of national management bodies; improvement of antimicrobial stewardship (AMS) in hospitals; maintenance of surveillance systems for AMR; provision of trainings on AMR and antibiotics use to doctors and pharmacists; and organization of nation-wide educational campaigns. Limited cooperation between MOH management bodies, shortages of human resource at all health system levels, a low degree of agreement between national and hospital guidelines on antibiotic use, low capability in the domestic supply of standardised drugs, and unequal training opportunities for lower-level health professionals present ongoing challenges. Actions suggested for the next period of the NAPCA include a final review of what has been achieved by the plan so far and evaluating the effectiveness of the different components of the plan. Different options on how to improve coordination across sectors in the development of a new NAPCA should be put forward. Conclusions The 6-year implementation of the Vietnam NAPCA has yielded valuable lessons for AMS in Vietnam, guiding the development of future national plans, with a central focus on scaling up AMS in hospitals and promoting community AMS programs to combat AMR.

show abstract

Assessing feasibility of establishing antimicrobial stewardship programmes in two provincial-level hospitals in Vietnam: an implementation research study

et al. 2021

View full text Add to dashboard Cite

ObjectivesTo investigate the feasibility of establishing hospital-based antimicrobial stewardship (AMS) programmes comprising action-planning, educational interventions and data feedback in two provincial-level hospitals in Viet Nam.Design and settingThis was an implementation research using participatory action process and existing resources from the Duke Antimicrobial Stewardship Outreach Network with local adjustments. A national stakeholder meeting and Strengths-Weaknesses-Opportunities-Threats (SWOT) analysis were conducted to identify gaps and potential interventions.ParticipantsHospital AMS staff implemented activities throughout the study phases. Routinely collected patient data were analysed to support planning, implementation and evaluation.InterventionsHospitals were considered as a complex adaptive system and leveraged their unique characteristics and interconnections to develop 1-year plans containing core interventions (data use, educational training, prospective audit with feedback (PAF) and evaluations).Outcome measuresWe assessed feasibility using outputs from stakeholder meeting, SWOT analysis, baseline data, planning process and implementation.ResultsThe stakeholder meeting identified three gaps for AMS at national level: supportive policies, AMS training and core competencies and collaboration. At the hospitals, AMS programmes took 1 year for planning due to lack of hospital-specific procedures and relevant staff competencies. Baseline data (January–December 2019) showed variations in antibiotic consumption: 951 days of therapy (DOT) per 1000 days present in the control and 496 in the intervention wards in hospital 1, and 737 and 714 in hospital 2, respectively. During 1-year implementation, clinical pharmacists audited 1890 antibiotic prescriptions in hospital 1 (June 2020–May 2021) and 1628 in hospital 2 (July 2020–July 2021), and will continue PAF in their daily work.ConclusionOur data confirmed the need to contextualise AMS programmes in low-income and middle-income countries (LMICs) and demonstrated the usefulness of implementation research design in assessing programme feasibility. Developing staff competencies, using local data to stimulate actions and integrating programme activities in routine hospital work are key to success in LMICs.

show abstract

Antimicrobial Stewardship Program at a tertiary teaching hospital in Vietnam: A longitudinal observational study

Abstract: Introduction: Antimicrobial resistance is an emerging global problem, particularly in developing countries. Cho Ray is one of the first hospitals in Vietnam to implement an antimicrobial stewardship program. We present the results of this program here, after two years of implementation.

Cited by 3 publications

References 15 publications

Healthcare associated pneumonia: An old concept at a hospital with high prevalence of antimicrobial resistance

Healthcare associated pneumonia: An old concept at a hospital with high prevalence of antimicrobial resistance

Health system barriers to the implementation of the national action plan to combat antimicrobial resistance in Vietnam: a scoping review

Assessing feasibility of establishing antimicrobial stewardship programmes in two provincial-level hospitals in Vietnam: an implementation research study

Contact Info

Product

Resources

About