Antibiotic therapy for inpatients with community‐acquired pneumonia in a developing country

Trinh, Hieu T.; Hoang, Phuong H.; Cardona, Magnolia; Nguyen, Hai Trung; Vu, Dinh Hoa; Dong, Phuong Thi Xuan; Cao, Thao T. B.; Nguyen, Son Truong; Pham, Van Thi Thuy; Moss, Le; Dinh, Kathryn; Dartnell, Jonathan; Nguyen, Huong Thi

doi:10.1002/pds.3614

Cited by 9 publications

(7 citation statements)

References 15 publications

(22 reference statements)

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“…CAP is commonly seen in the elderly 10,11 and often results in poor prognosis and high mortality. 12 In this study, it was found that the in-hospital mortality rate in this population was 5.87%, which was consistent with previous studies [12][13][14] This high mortality rate indicates that particular attention should be paid to older patients with CAP.…”

Section: Discussionmentioning

confidence: 99%

Combined Neutrophil-to-Lymphocyte Ratio and CURB-65 Score as an Accurate Predictor of Mortality for Community-Acquired Pneumonia in the Elderly

Feng¹,

Zou²,

Zhou³

et al. 2021

IJGM

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Community-acquired pneumonia (CAP) is common among the elderly; it typically has a poor prognosis and high mortality. This study evaluated the factors predicting CAPrelated in-hospital mortality in the elderly to identify a simpler and more accurate predictor. Patients and Methods: This was a single-center, retrospective study. The data used in this study was collected from all older patients (≥65) with CAP admitted to our hospital between January 2012 and April 2020. Results: A total of 2028 older patients with CAP were included; 121 (5.97%) died in hospital. Of the patients in the study, 1267 (62.5%) were men and 261 (12.9%) had a history of malignant tumors. After performing univariate and multivariate Cox regression analyses, sex, history of malignant tumor, CURB-65 score, neutrophil-to-lymphocyte ratio (NLR), hemoglobin level, and NLR*CURB-65 levels were associated with CAP mortality. By comparing the area under the receiver operating characteristic (ROC) curves of the predicted factors, the NLR*CURB-65 level used to predict CAP mortality in the elderly was 0.755, and was superior to other measurements. All included patients were then dichotomized into two groups based on NLR*CURB-65 level (≤9.06 and >9.06) according to the ROC analysis. Patients with a high NLR*CURB-65 level had higher inhospital mortality than those with a low NLR*CURB-65 level. The two divided groups showed significant differences in age, sex, smoking history, comorbidity, and laboratory findings. This indicates that NLR*CURB-65 is a predictive index that could reflect the comprehensive condition of older patients with CAP. Conclusion: NLR*CURB-65 is a simpler and more accurate predictor of CAP-related inhospital mortality in the elderly.

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Section: Discussionmentioning

confidence: 99%

Combined Neutrophil-to-Lymphocyte Ratio and CURB-65 Score as an Accurate Predictor of Mortality for Community-Acquired Pneumonia in the Elderly

Feng¹,

Zou²,

Zhou³

et al. 2021

IJGM

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“…In a multicentre study on CAP, widespread use of intravenous third-generation cephalosporins was observed (29.3% as monotherapy and 40.4% as combination therapy) regardless of infection severity. 61 Irrational antibiotic use along with guideline non-compliance might be explained by the lack of local microbiology data-driven guidance, patient-expectation oriented prescribing behaviour, lack of consultation time with each patient and promotion of broad-spectrum antibiotic use by pharmaceutical companies. 62 Therefore, antimicrobial stewardship teams in Vietnam should elaborate the guidelines with local microbiological data, as well as integrate and disseminate the guidelines to doctors.…”

Section: Local Insightmentioning

confidence: 99%

Country data on AMR in Vietnam in the context of community-acquired respiratory tract infections: links between antibiotic susceptibility, local and international antibiotic prescribing guidelines, access to medicines and clinical outcome

Torumkuney

Kundu²,

et al. 2022

Journal of Antimicrobial Chemotherapy

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Background Antimicrobial resistance (AMR) is one of the biggest threats to global public health. Selection of resistant bacteria is driven by inappropriate use of antibiotics, amongst other factors. COVID-19 may have exacerbated AMR due to unnecessary antibiotic prescribing. Country-level knowledge is needed to understand options for action. Objectives To review the current situation with respect to AMR in Vietnam and initiatives addressing it. Identifying areas where more information is required will provide a call to action to minimize any further rises in AMR within Vietnam and improve patient outcomes. Methods National initiatives to address AMR in Vietnam, antibiotic use and prescribing, and availability of susceptibility data, in particular for the key community-acquired respiratory tract infection (CA-RTI) pathogens Streptococcus pneumoniae and Haemophilus influenzae, were identified. National and international antibiotic prescribing guidelines for CA-RTIs (community-acquired pneumonia, acute otitis media and acute bacterial rhinosinusitis) commonly used locally were also reviewed, plus local antibiotic availability. Insights from clinicians in Vietnam were sought to contextualize this information. Conclusions In Vietnam there have been some initiatives addressing AMR; Vietnam was the first country in the Western Pacific Region to develop a national action plan to combat AMR, which according to the WHO is being implemented. Vietnam also has one of the highest rates of AMR in Asia due, in part, to the overuse of antimicrobial drugs, both in the animal health sector and in humans in both hospitals and the community. In addition, despite a 2005 law requiring antibiotic prescription, there is unrestricted access to over-the-counter antibiotics. Several global surveillance studies provide antibiotic susceptibility data for CA-RTI pathogens in Vietnam including Survey of Antibiotic Resistance (SOAR) and SENTRY (small isolate numbers only). For management of the common CA-RTIs in Vietnam there are several country-specific local antibiotic prescribing guidelines and in addition, there is a range of international guidelines referred to, but these may have been created based on pathogen resistance patterns that might be very different to those in Vietnam. Expert clinician opinion confirms the high resistance rates among common respiratory pathogens. A more standardized inclusive approach in developing local guidelines, using up-to-date surveillance data of isolates from community-acquired infections in Vietnam, could make management guideline use more locally relevant for clinicians. This would pave the way for a higher level of appropriate antibiotic prescribing and improved adherence. This would, in turn, potentially limit AMR development and improve clinical outcomes for patients.

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“…Опыт ряда зарубежных исследований демонстрирует аналогичную тенденцию. Так, в работе Trinh HT и соавт., 2015 [32]…”

Section: результаты исследования и их обсуждениеunclassified

Comparative pharmacoepidemiological characteristics of antibacterial drugs prescriptions used in patients with lower respiratory tract infection in a typical practice in Kursk and Chisinau

Поветкин¹,

Gikavy²,

Levashova³

et al. 2022

Humans and their Health

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Objective: to study the structure of medical prescriptions for antibacterial drugs used in patients with various types of infection of the bronchopulmonary system in the conditions of typical practice in Kursk (Russian Federation) and Chisinau (Republic of Moldova). Materials and methods. In order to assess the structure of prescribing various classes of antibacterial agents used to treat patients with infections of the respiratory system, a survey of doctors from medical organizations in Kursk and Chisinau was conducted in the period from October 2019. to January 2020 as a one-time descriptive study. As model diseases are taken: acute bronchitis with purulent sputum, exacerbation of chronic obstructive pulmonary disease with purulent sputum, non-severe community-acquired pneumonia. Results. The leaders in prescription for acute bronchitis with purulent sputum were cephalosporins: in Kursk, their share was 24% (cefixime was most often prescribed), and in Chisinau, 26.8% (leaders were cefixime and ceftriaxone). In patients with exacerbation of chronic obstructive pulmonary disease and purulent sputum, doctors from both cohorts also more often recommended cephalosporins: 29.4% and 36.1% for Kursk and Chisinau, respectively; among them, cefixime, ceftriaxone and cefotaxime were leaders in Kursk, while ceftriaxone, cefotaxime and cefuroxime axetil were the priorities in Chisinau. For non-severe community-acquired pneumonia, doctors in Kursk preferred macrolides (more often - azithromycin and clarithromycin), inhibitor-protected penicillins (more often - amoxicillin/clavulanate) and cephalosporins (mainly of the 3rd generation), in Chisinau, cephalosporins (mainly of the 3rd generation) and penicillins (including inhibitor-protected) were more often prescribed, the proportion of macrolides was significantly less. Conclusion. Doctors from Chisinau and Kursk implement pharmacotherapy for this group of patients in accordance with modern clinical guidelines; at the same time, cases of irrational use of certain medicines are recorded.

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Antibiotic therapy for inpatients with community‐acquired pneumonia in a developing country

Cited by 9 publications

References 15 publications

Combined Neutrophil-to-Lymphocyte Ratio and CURB-65 Score as an Accurate Predictor of Mortality for Community-Acquired Pneumonia in the Elderly

Combined Neutrophil-to-Lymphocyte Ratio and CURB-65 Score as an Accurate Predictor of Mortality for Community-Acquired Pneumonia in the Elderly

Country data on AMR in Vietnam in the context of community-acquired respiratory tract infections: links between antibiotic susceptibility, local and international antibiotic prescribing guidelines, access to medicines and clinical outcome

Comparative pharmacoepidemiological characteristics of antibacterial drugs prescriptions used in patients with lower respiratory tract infection in a typical practice in Kursk and Chisinau

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