KHẢO SÁT ĐẶC ĐIỂM SỬ DỤNG KHÁNG SINH TRÊN BỆNH NHÂN MẮC ĐỢT CẤP BỆNH PHỔI TẮC NGHẼN MẠN TÍNH ĐIỀU TRỊ NỘI TRÚ TẠI BỆNH VIỆN NHÂN DÂN GIA ĐỊNH

Abstract

Introduction: Inappropriate antibiotic use in the treatment of chronic obstructive pulmonary disease exacerbation (ECOPD) may lead to treatment failures, increased hospital stays and medical costs. Objectives: To investigate the characteristics of ECOPD, the pattern and appropriateness of antibiotics used in the treatment of ECOPD and to determine factors associated with appropriate antibiotic use. Material and Methods: A cross-sectional study was conducted on medical records of inpatients with ECOPD at the Respiratory Department, Nhan dan Gia Dinh Hospital from 1st January to 30th June 2023. Data collected were patient and treatment characteristics, treatment outcomes. The appropriateness of antibiotic use was evaluated using the Ministry of Health (2018) and GOLD (2023) treatment guidelines. Logistic regression was used to determine factors associated with appropriate antibiotic use, with p < 0,05. Results: There were 118 medical records of inpatients with ECOPD included in the study. Most of patients were male (91.5%), being ≥ 65 year-old (68.6%), with moderate to severe ECOPD (69.5%). Eighty-six patients (72.9%) received antibiotics. Betalactam (± betalactamase inhibitor) + quinolone combinations (46.5%) and betalactam (± betalactamase inhibitor) monotherapy (40.7%) were the most commonly used antibiotic regimens. The rates of appropriate initial and overall antibiotic use were 34.9% and 46.6%, respectively. Patients with moderate to severe exacerbation were less likely to receive appropriate antibiotics than those with mild exacerbation (OR = 0.311; 95% CI 0.127 - 0.763; p = 0.011). Conclusion: Antibiotic use in hospitalized patients with ECOPD was suboptimal. Effective interventions are needed to improve the appropriateness of antibiotic use.