Thực trạng sử dụng kháng sinh theo kinh nghiệm trong điều trị nhiễm khuẩn tiết niệu tại Việt Nam=A review of empirical antibiotic use practices in treating urinary tract infections in Vietnam

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Tác giả: Tiến Dương Đoàn, Văn Chúc Hoàng, Hoài Bắc Nguyễn

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2024

Mô tả vật lý: tr.16-23

Bộ sưu tập: Metadata

ID: 242663

Thêm vào giỏ

Nghiên cứu này được tiến hành nhằm khảo sát tình hình sử dụng kháng sinh theo kinh nghiệm để điều trị các bệnh lý NKTN phổ biến là viêm thận bể thận (VTBT), viêm bàng quang cấp (VBQC), viêm tiền liệt tuyến (VTLT) và viêm niệu đạo cấp (VNĐC) của 550 bác sĩ tham gia Hội nghị toàn quốc của Hiệp hội Thận - Tiết niệu Việt Nam (VUNA) năm 2023. Kết quả cho thấy 95,6% (531/550) các bác sĩ có làm xét nghiệm nuôi cấy và định danh vi khuẩn trước khi điều trị, và trong số đó 34,7% (191/550) làm một cách thường quy
60,9% (335/550) làm chỉ khi nghi ngờ NKTN. Tuy nhiên, tỷ lệ tuân thủ theo hướng dẫn hiện hành của Bộ Y tế (BYT) chỉ ở mức 74,0% đối với điều trị VTBT, 59,1% đối với điều trị VTLT, 44,7% đối với điều trị VNĐC, và 33,3% đối với điều trị VBQC. Ciprofloxacin (23,1%), Levofloxacin (16,9%), Ceftriaxon (12,1%) là những kháng sinh được sử dụng phổ biến nhất để điều trị theo kinh nghiệm. Tỷ lệ khỏi trung bình sau điều trị theo kinh nghiệm được báo cáo ở mức 73,1% với VTBT, 77,9% với VBQC, 71,9% với VTLT và 76,3% với VNĐC. Bác sĩ thuộc chuyên ngành Nội thận - tiết niệu có tỷ lệ tuân thủ phác đồ điều trị VTBT và VBQC ở mức cao hơn các chuyên ngành khác. Các yếu tố như trình độ học vấn, số năm kinh nghiệm không làm thay đổi việc tuân thủ phác đồ được khuyến cáo trong điều trị (p>
0,05). Nghiên cứu chỉ ra thực trạng đáng lo ngại về tuân thủ phác đồ trong thực hành sử dụng kháng sinh điều trị các bệnh nhiễm khuẩn tiết niệu thường gặp trên lâm sàng. Trước tình hình đó, cần thực hiện cập nhật các hướng dẫn điều trị hiện tại phù hợp với tình hình kháng thuốc chung của thể giới để tăng cường hiệu quả điều trị cho người bệnh.Urinary tract infections (UTIs) are among the most prevalent infections today. The rapid increase in antibiotic resistance among UTI pathogens is a significant concern, with one of the primary contributors being the inappropriate use of antibiotics. This study was conducted to investigate the patterns of empirical antibiotic use for treating common UTI conditions— pyelonephritis, acute cystitis, prostatitis, and acute urethritis—among 550 physicians who participated in the 2023 National Congress of the Vietnam Nephrology - Urology Association (VUNA). The results reveal that 95.6% (531/550) of the physicians performed bacterial culture and identification prior to treatment, with 34.7% (191/550) doing so routinely and 60.9% (335/550) only when UTI was suspected. However, adherence to the current Ministry of Health (MOH) guidelines was only 74.0% for pyelonephritis, 59.1% for prostatitis, 44.7% for acute urethritis, and 33.3% for acute cystitis. Ciprofloxacin (23.1%), Levofloxacin (16.9%), and Ceftriaxone (12.1%) were the most commonly used antibiotics empirically. The average reported cure rates were 73.1% for pyelonephritis, 77.9% for acute cystitis, 71.9% for prostatitis, and 76.3% for acute urethritis. Physicians specializing in nephrology and urology had higher adherence rates to treatment protocols for pyelonephritis and acute cystitis compared to other specialties. Factors such as educational background and years of experience did not significantly affect adherence to recommended treatment protocols (p>
0.05). This study highlights a concerning situation regarding adherence to treatment guidelines for empirical antibiotic use in common UTI cases. In response, there is a need to update current treatment guidelines to align with global antibiotic resistance trends to enhance treatment efficacy.

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