Effectiveness of an enhanced antibiotic stewardship programme amongst paediatric patients in a tertiary hospital in Vietnam

Hoa Quoc Nguyen, Thi Hai Yen Nguyen, Huynh Phuong Thao, Le Dang Tu Nguyen, Nga Thi-Quynh Nguyen, Yingfen Hsia

Research output: Contribution to journalArticlepeer-review

Abstract

Background
In 2016, the Vietnamese Ministry of Health promoted development of antimicrobial stewardship for hospitals.

Aim
To evaluate the effectiveness and safety of the enhanced antibiotic stewardship programme (ASP) compared to the original ASP amongst paediatric patients at a tertiary hospital for infectious diseases in Vietnam.

Methods
We conducted an interrupted time series analysis to examine antibiotic use in paediatric patients aged 0 to 17 years admitted to the Hospital for Tropical Diseases in Ho Chi Minh City from April 2016 to March 2020. Outcomes measured were defined daily doses (DDDs) per 1000 patient-days; antibiotic days of therapy (DOT) per 1000 patient-days; percentage of antibiotic use by the WHO Access, Watch, and Reserve (AWaRe) system; Access-to-Watch ratio; and worse clinical outcomes at discharge.

Findings
Of 60,172 admissions during the study period, 28,019 received at least one antibiotic (46.6%) during hospital stay. The Watch antibiotics were the most commonly prescribed (78.1% of total antibiotic courses). The enhanced ASP did not improve antibiotic prescribing by DDDs per 1000 patient-days (RR: 1.05, 95%CI: 0.94-1.17) and DOT per 1000 patient-days (RR: 1.11, 95%CI: 0.99-1.25) compared to the original ASP. However, the percentage of Access antibiotics prescribed, and the Access-to-Watch ratio increased after the enhanced ASP (RR: 1.73, 95%CI: 1.38-2.17). There was no significant difference in worse clinical outcomes at discharge between the original and enhanced ASP (RR: 1.25, 95%CI: 0.78-2.00).

Conclusion
The enhanced ASP had modest impact on antibiotic consumption in paediatric population despite the improvement of Access antibiotic use and the Access-to-Watch ratio.
Original languageEnglish
JournalThe Journal of hospital infection
Early online date14 Jun 2022
DOIs
Publication statusEarly online date - 14 Jun 2022

Keywords

  • paediatric
  • Vietnam
  • antimicrobial stewardship programme

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