PHÂN TÍCH TÌNH HÌNH SỬ DỤNG KHÁNG SINH CARBAPENEM TRONG ĐIỀU TRỊ MỘT SỐ BỆNH NHIỄM KHUẨN TIÊU HÓA TẠI KHOA NGOẠI TỔNG HỢP – BỆNH VIỆN ĐA KHOA TÂM ANH GIAI ĐOẠN 2025-2026

Abstract

Background: Optimizing the rational use of carbapenems is a key factor in limiting the emergence and spread of multidrug-resistant bacterial strains.

Objectives: To analyze the current status of carbapenem use in the treatment of gastrointestinal infections at General Surgery Department during the 2025-2026 period.

Methods: A retrospective, descriptive cross-sectional study was conducted on 54 patients with gastrointestinal infections who were prescribed carbapenems at General Surgery Department from 01/01/2025-01/04/2026.

Results: The median age of patients was 66.5 years, with males accounting for 63%, and 57.4% of patients had at least one comorbidity. The diagnosed infections included intra-abdominal infections (46.3%), acute cholecystitis (40.7%), and anorectal abscesses/fistulas (13%). icrobiological cultures were obtained from 39 patients, of which 24 (61.5%) yielded positive results. Escherichia coli was the most production prevalent pathogen (83.3%), with 60% demonstrating extended-spectrum beta-lactamase (ESBL). The utilization rates of carbapenem-containing regimens in initial and subsequent therapies were 57.4% and 100%, respectively. Combination therapy represented 83.9% of carbapenem use, predominantly involving meropenem in combination with metronidazole (95.7%). The rate of appropriate empirical carbapenem prescribing, based on the risk of multidrug-resistant (MDR) bacterial infection, was 28.0%. All patients continued carbapenem therapy until discharge, regardless of antimicrobial susceptibility test results. However, dose adjustments based on renal function were appropriate in 100% of cases.

Conclusions: Prioritizing the assessment of multidrug-resistant infection risks and enhancing the role of clinical pharmacy are essential to optimize carbapenem prescriptions and limit unnecessary antibiotic combinations.