Outpatient antibiotic prescribing for acute respiratory infections in Vietnamese primary care settings by the WHO AWaRe (Access, Watch and Reserve) classification: an analysis using routinely collected electronic prescription data

Nguyen, Nam Vinh; Thuy, Nga Thi; Vu, Dung Tien Viet; Greer, Rachel; Dittrich, Sabine; Vandendorpe, Maida; Pham, Thach Ngoc; Ta, Ngan Thi Dieu; Thai, Pham Quang; Khuong, Vinh  Thanh; Le, Thuy Thi Bich; Anh, Lai Tuan; Cao, Thai Hung; Trinh, Tung Son; Nguyen, Ha Thanh; Ngo, Long Nhat; Vu, Thom Thi; Doorn, H. Rogier van; Lubell, Yoel; Lewycka, Sonia

doi:10.1016/j.lanwpc.2022.100611

Cited by 12 publications

(12 citation statements)

References 45 publications

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“…Another study also reported that 30% of antibiotic use was irrational, and ceftriaxone was found to be the most used antibiotic (Diah, 2022). Similar findings have also been reported from an evaluation of antibiotic use conducted in Vietnam revealing a high proportion of antibiotic prescriptions for acute respiratory infections (ARI) in primary health care and high use of antibiotics from Watch class in children (Nguyen et al, 2023). These indicate that monitoring and evaluation of antibiotics use to achieve the prudent use of antibiotics should be continuously conducted.…”

Section: Introductionsupporting

confidence: 66%

Five Years Outpatients Antibiotics Consumption at Public Tertiary Hospital in Bengkulu According to Access, Watch and Reserve Classification

Apriyanti,

Saepudin,

Siti Maisharah S. Gadzi

2023

JFIKI

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Background: Access, Watch, and Reserve (AWaRe) antibiotics classification was released in 2019 by the World Health Organization (WHO) to enhance antimicrobial stewardship programs in all healthcare facilities. As a result, WHO advises global action to increase the availability of antibiotics from the Access group by more than 60%.Objective: to determine antibiotics consumption for outpatients at a public tertiary hospital in Bengkulu, Sumatera-Indonesia, from 2018 to 2022, focusing on antibiotics from Access class according to the AWaRe classification from WHO and Ministry of Health Republic of Indonesia (MoHRI). Methods: This is a cross-sectional survey analyzing aggregate data on antibiotics use for outpatients at the hospital during the study period. Data on antibiotics were collected from the hospital pharmacy department, while data on patient visits were collected from the medical records department. The quantity of antibiotics used was calculated using the ATC/DDD method and expressed in DDD/1000 patient-day (PD), which was then converted into a percentage. Results: During the study period, 50-60% and 65-73% out of 14-19 antibiotic agents are from Access class according to WHO and MoHRI AWaRe classification, respectively. Quantitatively, according to the WHO and MoHRI AWaRe classification, the consumption of antibiotics from the Access class was 25-50% and 33-71% of total consumption, respectively. In addition, the segment of drug utilization 90% (DU90%) of antibiotics was dominated by antibiotics from Watch class. Conclusion: The hospital has not yet met the WHO target for antibiotic consumption from the Access class, highlighting the need for some effective efforts from Watch class to limit the usage of antibiotics.

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Section: Introductionsupporting

confidence: 66%

Five Years Outpatients Antibiotics Consumption at Public Tertiary Hospital in Bengkulu According to Access, Watch and Reserve Classification

Apriyanti,

Saepudin,

Siti Maisharah S. Gadzi

2023

JFIKI

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“…Acute respiratory infections is a major reason for antibiotic use in children ( 74 ). Excessive and irrational antibiotic use is well documented all over the world and contributes to antimicrobial resistance (AMR) within the community.…”

Section: Pneumonia Managementmentioning

confidence: 99%

The dilemma of improving rational antibiotic use in pediatric community-acquired pneumonia

Nguyen

Robinson²,

Fitzgerald³

et al. 2023

Front. Pediatr.

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Pneumonia is the number one cause of disease and deaths in children under five years old, outside the neonatal period, with the greatest number of cases reported from resource-limited settings. The etiology is variable, with not much information on the local etiology drug resistance profile in many countries. Recent studies suggest an increasing contribution from respiratory viruses, also in children with severe pneumonia, with an increased relative contribution in settings that have good vaccine coverage against common bacterial pathogens. Respiratory virus circulation was greatly reduced during highly restrictive measures to contain the spread of COVID-19 but rebounded once COVID-19 restrictions were relaxed. We conducted a comprehensive literature review of the disease burden, pathogens, case management and current available prevention of community acquired childhood pneumonia, with a focus on rational antibiotic use, since the treatment of respiratory infections is the leading cause of antibiotic use in children. Consistent application of revised World Health Organisation (WHO) guidance that children presenting with coryzal symptoms or wheeze can be managed without antibiotics in the absence of fever, will help to reduce unnecessary antibiotic use, as will increased availability and use of bedside inflammatory marker tests, such as C–reactive protein (CRP) in children with respiratory symptoms and fever.

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“…A recent paper in the Lancet Regional Health 2 provides insights into antibiotic overuse in Vietnam as a case study for LMICs. Using robust data from electronic health records for a very large sample (n = 193,010 visits from 112 commune health centres), the authors reported an alarming rate of antibiotic overuse in Vietnamese rural primary care settings.…”

mentioning

confidence: 99%

“…First, the antibiotic overuse comes from patients. The recent Lancet Regional Health study 2 investigated patient characteristics as determinants of antibiotic choice. However, it failed to discuss determinants of the patient “self-medication”.…”

mentioning

confidence: 99%

“…Second, the antibiotic overuse is contributed by GP overprescribing. Unfortunately, data on characteristics of prescribers (GPs) were not available in the recent Lancet Regional Health study 2 to assess the GP determinants of antibiotic overprescribing. The authors recommended training in antimicrobial stewardship and communication skills for GPs and providing GPs in rural care settings with point of care diagnostic tests, specifically C-reactive protein (CRP), to guide antibiotic prescribing.…”

mentioning

confidence: 99%

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A real challenge to tackle the overuse of antibiotics in LMIC: a case from Vietnam

Bui¹,

Nguyen²

2023

The Lancet Regional Health - Western Pacific

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Outpatient antibiotic prescribing for acute respiratory infections in Vietnamese primary care settings by the WHO AWaRe (Access, Watch and Reserve) classification: an analysis using routinely collected electronic prescription data

Cited by 12 publications

References 45 publications

Five Years Outpatients Antibiotics Consumption at Public Tertiary Hospital in Bengkulu According to Access, Watch and Reserve Classification

Five Years Outpatients Antibiotics Consumption at Public Tertiary Hospital in Bengkulu According to Access, Watch and Reserve Classification

The dilemma of improving rational antibiotic use in pediatric community-acquired pneumonia

A real challenge to tackle the overuse of antibiotics in LMIC: a case from Vietnam

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