Drug use among children under 5 with respiratory illness and/or diarrhoea in a rural district of Vietnam

Hoan, Le; Chúc, Nguyễn Thị Kim; Ottosson, Ellinor; Allebeck, Peter

doi:10.1002/pds.1730

Cited by 20 publications

(20 citation statements)

References 30 publications

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“…Antibiotic use was not related to carriage which we cannot explain. Antibiotic use in the community was high, but comparable to previous studies that assessed community antibiotic use in Vietnam [21], [22], [23]. Interestingly, we found two cases who carried carbapenem resistant K. pneumoniae strains, which were found to be NDM-1 positive.…”

Section: Discussionsupporting

confidence: 87%

Klebsiella pneumoniae Oropharyngeal Carriage in Rural and Urban Vietnam and the Effect of Alcohol Consumption

et al. 2014

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IntroductionCommunity acquired K. pneumoniae pneumonia is still common in Asia and is reportedly associated with alcohol use. Oropharyngeal carriage of K. pneumoniae could potentially play a role in the pathogenesis of K. pneumoniae pneumonia. However, little is known regarding K. pneumoniae oropharyngeal carriage rates and risk factors. This population-based cross-sectional study explores the association of a variety of demographic and socioeconomic factors, as well as alcohol consumption with oropharyngeal carriage of K. pneumoniae in Vietnam.Methods and Findings1029 subjects were selected randomly from age, sex, and urban and rural strata. An additional 613 adult men from a rural environment were recruited and analyzed separately to determine the effects of alcohol consumption. Demographic, socioeconomic, and oropharyngeal carriage data was acquired for each subject. The overall carriage rate of K. pneumoniae was 14.1% (145/1029, 95% CI 12.0%–16.2%). By stepwise logistic regression, K. pneumoniae carriage was found to be independently associated with age (OR 1.03, 95% CI 1.02–1.04), smoking (OR 1.9, 95% CI 1.3–2.9), rural living location (OR 1.6, 95% CI 1.1–2.4), and level of weekly alcohol consumption (OR 1.7, 95% CI 1.04–2.8).ConclusionModerate to heavy weekly alcohol consumption, old age, smoking, and living in a rural location are all found to be associated with an increased risk of K. pneumoniae carriage in Vietnamese communities. Whether K. pneumoniae carriage is a risk factor for pneumonia needs to be elucidated.

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Section: Discussionsupporting

confidence: 87%

Klebsiella pneumoniae Oropharyngeal Carriage in Rural and Urban Vietnam and the Effect of Alcohol Consumption

et al. 2014

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“…As such, use of antibiotics, such as metronidazole, cotrimoxazole and amoxicillin as seen in the current study, confers limited benefits but serves to select for resistant bacterial pathogens. Studies in similar settings have reported comparable health worker practices for patients with acute non-bloody diarrhoea [28,29].…”

Section: Discussionmentioning

confidence: 95%

Antibiotic prescribing practices for patients with fever in the transition from presumptive treatment of malaria to ‘confirm and treat’ in Zambia: a cross‐sectional study

Ndhlovu¹,

Nkhama²,

Miller

et al. 2015

Tropical Med Int Health

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Abstractobjectives To evaluate antibiotic use among patients presenting to primary healthcare facilities with febrile illness in Zambia.methods We analysed data from a 2011 nationwide cross-sectional health facility survey of routine malaria case management in Zambia. Patient consultation observation and medical record charts were used to calculate the proportion of febrile patients who were prescribed antibiotics, stratified by symptoms, health workers' diagnosis and malaria test results. Logistic regression was used to identify factors affecting antibiotic prescribing behaviour. conclusions Testing positive for malaria or receiving a malaria diagnosis was associated with reduced antibiotic prescribing, while testing negative, not being tested or a diagnosis of URTI resulted in higher rates of antibiotic prescribing. There is a need for improving diagnostic capacity for nonmalaria causes of febrile illness at healthcare delivery points and limiting antibiotic use to patients with definite bacterial infections.

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“…One important factor is probably the frequent and irrational use of antibiotics that constitutes a constant selective pressure. In this study area, many children frequently use antibiotics [10,34]; antibiotic use was also higher among children with pneumococcal resistant strains. The higher level of co-trimoxazole and multidrug resistance in the mountainous area may mainly be due to higher use of co-trimoxazole in this area and leading to differential selective pressure in different areas.…”

Section: Discussionmentioning

confidence: 99%

“…Further, the genetic determinants for resistant clones usually exist in a stable form, so once resistance is established, it is not easily lost [36]. Although the use of tetracycline in the region recently is very low compared to three decades ago, the persistence of high resistance to this antibiotic indicates the stability of the resistant clones [34]. High resistance to ciprofloxacin among the strains of children could be due to the spread of already resistant strains from adults [3,39].…”

Section: Discussionmentioning

confidence: 99%

Decreased Streptococcus pneumoniae susceptibility to oral antibiotics among children in rural Vietnam: a community study

et al. 2010

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BackgroundStreptococcus pneumoniae is the most significant bacterial cause of community-acquired pneumonia among children under five years worldwide. Updated resistance information of S. pneumoniae among children is essential to adjust the recommendations for empirical treatment of community-acquired pneumonia, which will have immense implications for local and global health. This study investigated the prevalence of antibiotic resistance in isolated strains of S. pneumoniae and relationship with antibiotic use and demographic factors of children under five in rural Vietnam in 2007.MethodsIn Bavi district, 847 children 6 to 60 months were selected from 847 households. The main child-caregivers in the households were interviewed weekly using structured questionnaires to collect information of daily illness symptoms and drug use for the selected child over a four-week period (from March through June 2007). In the 3rd week, the children were invited for a clinical examination and to collect nasopharyngeal samples for S. pneumoniae identification. Etest and disk diffusion were used to test antibiotic susceptibility.ResultsOf 818 participating children, 258 (32%) had ongoing respiratory infections, 421 (52%) carried S. pneumoniae, and 477 (58%) had used antibiotics within the previous three weeks. Of the 421 isolates, 95% were resistant to at least one antibiotic (401/421). Resistance to co-trimoxazole, tetracycline, phenoxymethylpenicillin, erythromycin and ciprofloxacin was 78%, 75%, 75%, 70% and 28%, respectively. Low resistance was noted for amoxicillin (4%), benzylpenicillin (4%), and cefotaxime (2%). The intermediate resistance to amoxicillin was 32%. Multidrug-resistance was seen in 60%. The most common pattern was co-resistance to co-trimoxazole, tetracycline and erythromycin. The proportion of children carrying resistant bacteria was higher among the children who had used antibiotics in the previous three weeks.ConclusionsResistance to commonly used antibiotics and multidrug-resistance of S. pneumoniae in the area is remarkably high. High-dose amoxicillin is the only investigated oral antibiotic that can possibly be used for treatment of community-acquired pneumococcal infections. Strategies to promote appropriate prescribing and dispensing of effective antibiotics should be immediately implemented for the benefit of local and global health.

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Drug use among children under 5 with respiratory illness and/or diarrhoea in a rural district of Vietnam

Cited by 20 publications

References 30 publications

Klebsiella pneumoniae Oropharyngeal Carriage in Rural and Urban Vietnam and the Effect of Alcohol Consumption

Klebsiella pneumoniae Oropharyngeal Carriage in Rural and Urban Vietnam and the Effect of Alcohol Consumption

Antibiotic prescribing practices for patients with fever in the transition from presumptive treatment of malaria to ‘confirm and treat’ in Zambia: a cross‐sectional study

Decreased Streptococcus pneumoniae susceptibility to oral antibiotics among children in rural Vietnam: a community study

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