Khảo sát tình hình sử dụng kháng sinh trong điều trị viêm phổi bệnh viện tại Bệnh viện Nhân dân Gia Định năm 2022

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Tác giả: Bình Thuận Hà, Hồng Thắm Phạm, Thị Phương Uyên Trần

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Khoa học và Công nghệ - Đại học Nguyễn Tất Thành, 2023

Mô tả vật lý: tr.95

Bộ sưu tập: Metadata

ID: 381012

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Hospital-acquired pneumonia (HAP) is often caused by multi-antibiotic resistant bacteria, and is associated with a high mortality rate. The project was conducted with the goal of surveying compliance of antibiotic use with IDSA/ATS 2016 guidelines in the treatment of HAP. The cross-sectional, descriptive, retrospective research focused on the medical records of patients diagnosed with HAP Gia Dinh People's Hospital in 2022 with a sample size of 250 medical records. Results have shown that the average age of patients was (67.45 ± 15.8) years, with 54,4 % of which were male. Empirical initial antibiotics treatment showed that b-lactam was the most prescribed (82.5 %) which is consistent with the instructions, followed by piperacillin/tazobactam and levofloxacin (10 %). The main pathogens were found as multi-resistant Gram-negative bacteria (79.4 %), mostly A. baumannii (26.5 %). There were 95 patients undergoing antibiogram (38 %). After treating with antibiotics (usually colistin + ampicillin/sulbactam regimen (7,8 %). There was 73.4 % of regimens were used according to antibiogram. There was 68 % of patients were treated successfully. Overall, the most commonly found pathogen in HAP is highly resistant Gram-negative bacteria with. The most commonly used antibiotic group is b-lactam. The use of antibiotics is relatively consistent with the instructions.Viêm phổi bệnh viện thường do các vi khuẩn đa kháng thuốc và có tỉ lệ tử vong cao. Mục tiêu của đề tài nhằm khảo sát việc tuân thủ sử dụng kháng sinh với hướng dẫn của Hội các bệnh nhiễm khuẩn Hoa Kỳ (IDSA) và Hiệp hội lồng ngực Hoa Kỳ (ATS) năm 2016 về chẩn đoán và điều trị viêm phổi bệnh viện. Đối tượng và phương pháp nghiên cứu: cắt ngang mô tả, hồi cứu trên hồ sơ bệnh án của bệnh nhân được chẩn đoán viêm phổi bệnh viện tại Bệnh viện Nhân dân Gia Định trong năm 2022. Kết quả: thu thập 250 hồ sơ bệnh án, tuổi trung bình là 67,45 ± 15,8
nam chiếm 54,4 %. Kháng sinh điều trị ban đầu theo kinh nghiệm: b-lactam được dùng nhiều nhất, có 82,5 % hoạt chất kháng sinh phù hợp với hướng dẫn, thường sử dụng piperacillin/tazobactam + levofloxacin (10%). Tác nhân chủ yếu là vi khuẩn gram âm đa kháng (79,4 %): nổi bật là A. baumannii (26,5 %). Có 38 % bệnh nhân được làm kháng sinh đồ. Sau khi có kháng sinh đồ: thường sử dụng colistin + ampicillin/sulbactam (7,8 %). 73,4 % phác đồ dùng theo kháng sinh đồ. 68 % bệnh nhân đã được điều trị thành công. Kết luận: tác nhân phổ biến nhất trong viêm phổi bệnh viện là vi khuẩn gram âm, có tỷ lệ đề kháng cao. Việc sử dụng kháng sinh tương đối tuân thủ theo hướng dẫn.

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