INVESTIGATION ON THE APPROPRIATE USE OF CARBAPENEM AND RESPONSE TO THIS ANTIBIOTIC GROUP IN GERIATRIC PATIENTS

Nguyễn Thị Mai Hoàng1, Nguyễn Phương Trang1, Phạm Hồng Thắm2, Nguyễn Ngọc Khôi1,
1 University of Medicine and Pharmacy at Ho Chi Minh City
2 Gia Dinh People's Hospital, Ho Chi Minh City

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Abstract

Introduction: This study was designed to investigate the appropriate use of carbapenem and older patients’ response to this antibiotic group at Geriatric Department of Nhan Dan Gia Dinh hospital. Methods: A retrospective, cross-sectional study was carried on medical records of inpatients at the Geriatric Department who had been prescribed carbapenem from October 1st 2020 to March 31st 2021. The appropriate use of carbapenem was evaluated based on recommendations of Vietnamese Ministry of Health 2015, of Ho Chi Minh City Department of Health 2018, Infectious Diseases Society of America, and Sanford Guide 2020. Patients’ response with antibiotic was evaluated after 3 days of use and at discontinuation of carbapenem by assessing the improvement on clinical symptoms and laboratory results. Results: The rates of appropriateness in indication and dosage of carbapenem observed in 113 medical records were 94.7% and 55.8%, respectively. Inappropriate dosage was due to the inappropriateness with patients’ kidney function. The rate of patients responding to carbapenem regimens after 3 days of use and at discontinuation was 35.3% and 34.3%, respectively. The rate of data lacking to evaluate the response to antibiotic after 3 days and at discontinuation was 27.5% and 17.6%, respectively.  Conclusion: The rates of appropriateness in carbapenem dosage and response to this antibiotic group amongst older patients were modest. Carbapenem dosages should be adjusted according to patients’ kidney function and adequate monitoring of laboratory results is required in the elderly.

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References

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