Antibiotic usage among the elderly in Tan Loi commune, Dong Hy district, Thai Nguyen province, Vietnam

Original Research

Abstract

Introduction: Antibiotic resistance has been determined as a global threat. Inappropriate use of antibiotics is a crucial driver of the evolution of resistance.

Methods: A cross-sectional study was conducted aiming to describe the antibiotic usage among the elderly (60 years old and above) in Tan Loi commune, Dong Hy district, Thai Nguyen province, Vietnam in 2020. The questionnaire survey was submitted to 370 participants.

Results: More than half of the participants were female. The proportion of the elderly who bought antibiotics using a prescription was 39.2%. The participants normally bought the medicines the same as the previous (53.0%), medicine seller’s advice (44.9%), and relatives/friends’ advice (15.4%). More than half of the participants bought antibiotics themselves (57.8%). Local private pharmacies and health centers/hospitals were common locations for buying antibiotics, 63.8%, and 34.1% respectively. The percentage of the participants who stopped taking antibiotics when the symptoms are gone was 54.1%. More than 50.0% of the participants would change to more expensive antibiotics in case of symptoms are not released after using antibiotics. Some factors significantly associated with prescription usage were education levels, ethnic, obtained information related to antibiotic uses, others helping to buy the antibiotics.

Conclusions: The proportion of the elderly using antibiotics with a prescription was low. Majority of the participants bought antibiotics from the local private pharmacies. The main source of information to buy antibiotics was as the last time and medicine sellers. Some factors significantly associated with prescription use were education level, ethnicity, obtained information related to antibiotic uses, individuals who buy the medicines. Interventions are needed to improve knowledge and practice in buying antibiotics not only for the elderly but also for health service providers, private pharmacies in particular. 

Graphical abstract

Healthcare associated pneumonia: An old concept at a hospital with high prevalence of antimicrobial resistance

Original Research

Abstract

Background: One of several reasons that the concept of healthcare-associated pneumonia (HCAP) was dismissed was the same presence of multidrug resistant organism (MDRO) between community-acquired pneumonia and HCAP at countries with the low prevalence of antimicrobial resistance (AMR). However, this finding could be unsuitable for countries with the high rates of AMR.

Methods: A prospective observational study was conducted at the respiratory department of Cho Ray hospital from September 2015 to April 2016. All adult patients suitable for community acquired pneumonia (CAP) with risk factor for healthcare-associated infection were included.

Results: We found out 130 subjects. The median age was 71 years (interquartile range 57-81). The male/female ratio was 1.55:1. Prior hospitalization was the most common risk factor for healthcare-associated infection. There were 35 cases (26.9%) with culture-positive (sputum and/or bronchial lavage). Isolated bacteria included Pseudomonas aeruginosa (9 cases), Klebsiella pneumoniae (9 cases), Escherichia coli (4 cases), Acinetobacter baumannii (6 cases), and Staphylococcus aureus (7 cases) with the characteristic of AMR similar to the bacterial spectrum associated with hospital-acquired pneumonia.

Conclusion: MDROs were detected frequently in CAP patients with risk factor for healthcare-associated infection at the hospital with the high prevalence of AMR. This requires the urgent need to evaluate risk factors for MDRO infection in community-onset pneumonia when the concept of HCAP is no longer used.

Graphical abstract

Staphylococcus aureus nasal colonization among Vietnamese adults: prevalence, risk factors and antibiotic susceptibility profile

Original Research

Abstract

Staphylococcus aureus (S. aureus) has long been recognized as an important human pathogen causing many severe diseases. It is also a part of human normal flora with its ecological niche in the human anterior nares. This study focused on screening S. aureus nasal carriage in community and its relationship to human physiological and pathological factors which have not been studied in Vietnam previously. Two hundred and five volunteers in Ho Chi Minh City from 18 to 35 and over 59 years old both male and female participated in the study. Result showed that the prevalence of S. aureus nasal carriage in southern Vietnamese community was relatively low, only 11.2% (23/205), much lower than that in other international reports on human S. aureus. In addition, nasal carriage of the older age group (> 59 years old, 13.7%) was higher than that of younger age (18-35 years old, 10.4%). Other potential risk factors such as gender, career, height, weight, history of antibiotic usage, daily nasal wash, use of nasal medication sprays, acne problems, smoking and nasal problems showed no significant impact on S. aureus carriage. The obtained S. aureus nasal isolates were all sensitive to vancomycin. Lincomycin and tetracycline had low resistance rate with 4.3 % and 17.4 %, respectively. However, the isolates showed particularly high rate of multidrug resistance (54.2%) In summary, our data provided researchers an overview on S. aureus nasal carriage and antibiotic susceptibility profile of the community- isolated S. aureus in Vietnam. This would serve as valuable information on assessing risk of community-acquired S. aureus infections.

Graphical abstract

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