KHẢO SÁT TÌNH HÌNH CHUYỂN ĐỔI KHÁNG SINH TỪ ĐƯỜNG TĨNH MẠCH SANG ĐƯỜNG UỐNG TRONG ĐIỀU TRỊ VIÊM PHỔI CỘNG ĐỒNG TẠI BỆNH VIỆN PHẠM NGỌC THẠCH

Abstract

Introduction: Intravenous-to-oral (IV–PO) antibiotic conversion is an important strategy in response to increasing antibiotic resistance, but has not been evaluated at Pham Ngoc Thach Hospital in the treatment of community-acquired pneumonia (CAP). Objectives: To investigate the current practice of antibiotic route conversion and evaluate treatment outcomes following IV-to-PO switch in hospitalized CAP patients at Pham Ngoc Thach Hospital. Methods: A retrospective cross-sectional study was conducted by reviewing medical records of patients aged ≥18 years who received intravenous (IV) antibiotics within the first 48 hours of hospitalization in four internal medicine departments, from November 1, 2023, to May 31, 2024. Eligibility criteria for IV-to-oral (IV-PO) antibiotic switch were based on Decisions No. 5631/QĐ-BYT and 4815/QĐ-BYT issued by the Ministry of Health of Vietnam (2020). The appropriateness of the switch was evaluated according to Decision No. 4815/QĐ-BYT (2020), ATS/IDSA guidelines, British Thoracic Society (BTS) guidelines, UpToDate, and the Sanford Guide 2024. Results: Among 304 patients analyzed, 154 (50.7%) were eligible for antibiotic switch. Of these, 128 patients continued IV antibiotics, and only 18% were actually switched to oral therapy. The overall appropriateness rate was 56.5%, with appropriate timing in 69.6%, appropriate antibiotic selection in 82.6%, and appropriate dosing in 100%. No significant differences were found between converted and non-converted groups in treatment success rate (100% vs. 99%, p = 1.000), hospital stay duration (13 vs. 11 days, p = 0.363), or IV antibiotic duration (11 vs. 10 days, p = 0.882). Conclusions: IV-to-PO antibiotic conversion remains underutilized at the hospital, despite comparable treatment effectiveness. Improvements in conversion timing and implementation of early-switch strategies involving clinical pharmacists are recommended