ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG Ở NGƯỜI BỆNH NHIỄM KHUẨN HUYẾT ĐƯỢC CHỈ ĐỊNH KHÁNG SINH VANCOMYCIN TRONG ĐIỀU TRỊ TẠI BỆNH VIỆN ĐA KHOA THANH VŨ MEDIC BẠC LIÊU NĂM 2023-2024

Abstract

Background: Sepsis is undeniably a serious worldwide health threat, causing millions of deaths each year and presenting a major challenge in treatment. Objectives: (1) To identify the clinical and paraclinical characteristics of patients with sepsis; (2) To determine the rate of positive blood cultures and the characteristics of vancomycin prescription in the treatment of sepsis at Thanh Vu Medic General Hospital in Bac Lieu. Materials and methods: A cross-sectional descriptive study was conducted using 60 medical records of hospitalized patients from the Emergency, Intensive Care, Internal Medicine, and Surgery departments, who were prescribed vancomycin for the treatment of sepsis at Thanh Vu Medic General Hospital, Bac Lieu, from January 1, 2023, to June 30, 2024. Results: The average age of patients was (67.8 ± 11.9) years, with 60.4% of patients being overweight or obese. Vital signs: body temperature >37.5°C in 26.6%, respiratory rate >20 breaths/min in 68.3%, heart rate >100 beats/min in 36.7%, and systolic blood pressure >140 mmHg in 25.0%. Paraclinical findings: elevated white blood cell count in 98.3%, Procalcitonin levels >0.04 ng/mL in 100%, venous lactate >2.2 mmol/L in 88.3%, increased PaCO2 in 38.3%, and elevated NEU% in 80%. Cardiovascular disease was the most common comorbidity (70%). 95% of patients had a creatinine clearance (Clcr) <90 ml/min. The most common source of infection was soft tissue (28.3%). Treatment was largely based on clinical experience (86.7%). The average duration of vancomycin use in patients ≥65 years old was longer compared to those <65 years old. Conclusions: Of the 60 medical records reviewed, the majority of patients prescribed vancomycin for sepsis were elderly, with underlying cardiovascular disease and impaired renal function. Treatment primarily relied on clinical experience, and the duration of vancomycin use was longer in patients aged ≥65 years.