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27/2020 Nghiên c u tình hình qu u tr ARV b nh nhân t qu can thi p t i B nh vi 2015 , Lu ih cC Nguy n Th Kh o sát tình hình s d ng thu c ARV tuân th u tr c a b nh nhân t i phòng khám ngo u tr HIV/AIDS, Trung tâm ki m soát b nh t t t nh B Lu ih c Hà N i, Hà N i , Alisha Monnette Concordance of Adherence Measurement Using Self-Reported Adherence Questionnaires and Medication Monitoring Devices: An Updated Review Pharmacoeconomics 2018 Jan, 36(1), pp.17-27 10 Hoa M Do, Michael P Dunne, Masaya Kato, Cuong Van Pham and Kinh V Nguyen (2013), section study using audio computer assissted self interview ( ACASI) BMC Infectious Diseases, 13(154), pp 1471-2334 11 Factors Affecting Adherence to Antiretroviral Therapy Clinical Infectious Diseases, 30 (Suppl 2), pp.171-6 12.Simona A lacob, Diana G lacob and Improving the Adherence to Antiretroviral Therapy, a Difficult but Essential Task for a Successful HIV Treatment Clinical Points of View and Practical Considerations Frontiers in Pharmacology, 8(831) 13 UNAIDS (2017), "90-90-90: an ambitious treatment target to help end the AIDS epidemic", Joint United Nations Programme on HIV/AIDS 14 Vale, F C, Santa-Helena, E T D., Santos, M A, Carvalho, W M D E S, Menezes, P R, ent and validation of the WebAd-Q il 15 WHO (2016), The use of antiretroviral drugs for treating and preventing HIV infection, Switzerland (Ngày nh n bài: / /2020 - Ngày CS PH I C g:25 / /2020) D NG KH NG SINH NG T U TR VIÊM Nguy n Th Ng c Anh1, Nguy n Th ng2*, Nguy o1 ih c Thành ph H Chí Minh ih cC *Email: nthang@ctump.edu.vn i nh c c y u t u tr n vi c s d ng kh ng sinh h p lý i tr ( 18 tr 98 c ch u 27/2020 nh c c y u t n vi K t qu : K t lu n: Kh ABSTRACT INVESTIGATION ON ANTIBIOTICS USED IN THE TREATMENT OF COMMUNITY-ACQUIRED PNEUMONIA AT A PUBLIC HOSPITAL IN HO CHI MINH CITY Nguyen Thi Ngoc Anh1, Nguyen Thang2*, Nguyen Huong Thao1 University of Medicine and Pharmacy at Ho Chi Minh city Can Tho University of Medicine and Pharmacy Background: The appropriate use of antibiotics in the treatment of community pneumonia (CAP) plays a very important role in the disease control Objectives: (1) To investigate the pattern and appropriateness of antibiotics used in the treatment of community-acquired pneumonia and treatment outcomes, and (2) to determine factors associated with the appropriateness of antibiotics used Materials and methods: A cross-sectional study was conducted to collect medical records of inpatients with CAP aged 18 or older and treated with antibiotics for at least days at the respiratory ward of a public hospital in Ho Chi Minh city, between 1st November 2018 and 29th April appropriateness of antibiotics used was evaluated using standard guidelines Logistic regression analysis was used to determine factors associated with the appropriateness of antibiotics used Results: There were 235 patients (138 males and 97 females) included in the study Majority of patients were older than 65 years old (median age was 70) Almost all patients had at least one comorbidity The most common comorbidity was hypertension (63.0%) In 98 (41.7%) patients, antibiotics were indicated in accordance with standard guidelines -lactam alone or in combination with fluoroquinolone were the most commonly used regimens The severity of CAP was associated with appropriateness of antibiotics indication Patients with moderate or severe CAP were more likely to be indicated proper antibiotics regimens than patients with mild CAP (p < 0.05) Conclusions: The appropriateness of antibiotics used in the treatment of CAP in the study hospital was suboptimal Proper interventions are needed to improve appropriateness of antibiotics used Keywords: antibiotic(s), community-acquired pneumonia (CAP) I l m t nh ng l bi n nh t i , nhiên ng th - 48,0%) [5] 99 Almatar (2015) 27/2020 vi l ch t 6,4% [14] u tr l i gian chi ph 16,1% [4], hay m t nghiên c u không h p lý m hi u qu , u tr p lý x nh c c y u t n tính h p lý vi c s d ng kh ng sinh II i tr c ch u tr u HSBA i tr 18 c ch n u tr 29/04/2019 HSBA c a BN c m ng y, BN tr n vi n, chuy n vi n ho c t tri n, nhi m HIV, ph n c thai ho trùng : u tr < c lao ti n c ch - 30/06/2019 : 01/11/2018 - 29/04/2019 01/11/2018 : B Y T 2015 [1,10,12] kháng sinh s d S li cs d : phân t ch th ng kê b ng ph n m m Microsoft Excel 2013 v nh c c y u t liên quan n vi 100 27/2020 : III (n=235) m (trung v , IQR) Tu i: 70 (59 - 80) 65 tu i < 65 tu i Gi i tính Nam N BMI: 21 (20-23) Thi u cân (BMI < 18,5) Bình ng (BMI t n 23) Th a cân ho c béo phì (BMI > 23) CrCl: 58 ± 24 ml/phút 90 ml/ph t 50 - 90 ml/ph t n < 50 ml/ph t < 10 ml/ph t M b nh m CURB-65 Nh 0-1 Trung b nh N ng YTNC nhi m Pseudomonas aeruginosa T n s (t l %) 145 (61,7) 90 (38,3) 138 (58,7) 97 (41,3) 31 (13,2) 150 (63,8) 54 (23,0) 23 (9,8) 116 (49,4) 93 (39,6) (1,3) 89 (37,9) 111 (47,2) 35 (14,9) 70 (29,8) xét: - m P aeruginosa l 29,8% P aeruginosa, Streptococcus spp clindamycin, trimethoprim-sulfamethoxazol, ceftazidim ceftriaxon - 13) ng - 25 ngày -lac 101 - 27/2020 c ph kh ng sinh kinh kháng sinh P aeruginosa l 63,8% cy ut n vi c s d ng kh T nh h p l v ch nh kh ng sinh kinh nghi m v sau c kh (n=235) nghi m s d ng, t l ph Phân nhóm m T l (%) 3,0 14 5,9 KSKN s d ng h p lý 91 38,7 KSKN s d ng h p lý chung 98 41,7 i KSKN sau có KS có ch li nh h c xét ti p T ns ng dùng * xét: sinh) 41,7% si - (n=235) ng v i nghiên c u h i c u c a Tr nh Thanh Hi u c ng s (2015) [16] ch có 52,2% b c làm xét nghi m vi sinh Xét nghi m vi sinh tìm tác nhân gây b c khuy n cáo th c hi n t t c p vi c bi t BN m b nh trung bình - n ng [17], nhiên t nghiên c u này, có th th y t l th c hành lâm sàng theo khuy n cáo l h nh làm xét nghi m vi sinh có ch m trùng b v ng cho vi h p tác nhân gây b n c t nh oxitin -lactam 102 27/2020 S aureus S pneumoniae enterococci), H influenzae, E coli, Klebsiella - Bacteroides [6] Chúng [8] -lactam t khác, [8] [16] Tuy cao [3] cy ut n vi c s d ng kh Vi c s d ng kháng sinh ph r ng tình tr ng c a BN c th hi n nghiên c u u tr v i kháng sinh có ph P aeruginosa , ch có 70 (29,8%) BN nh có YTNC m c P aeruginosa s nh ng c Pseudomonas l i có 18/70 c nh u tr v i kháng sinh có ph vi khu n bao ph - nh kháng sinh h c cách th n tr ph i h p kháng sinh - nh kháng sinh m pv p lý 103 27/2020 Kháng sinh -lactam B Y t (2015), -lactam fluoroquinolon nghiên cao ng d n s d ng kh ng sinh, Nh xu t b n Y h c, H N i, tr.76-78 -20 ", OAR) 2010 2011", , 12, tr.855 Almatar M A., Peterson G M., Thompson A., et al (2015), "Community-acquired pneumonia: why aren't national antibiotic guidelines followed?", International journal of clinical practice, 69(2), pp.259-266 Al-Tawfiq JaffarA, Momattin Hisham, Hinedi Kareem (2019), ''Empiric Antibiotic Therapy in the Treatment of Community-acquired Pneumonia in a General Hospital in Saudi Arabia'', J Glob Infect Dis, 11(2), pp.69-72 American Society of Health-SystemPharmacists (2011), Drug Information Essentials, p.201 Amin A N., Cerceo E A., Deitelzweig S B., et al (2014), "The hospitalist perspective on treatment of community-acquired bacterial pneumonia", Postgraduate medicine, 126(2), pp.18-28 Chen Liang, Zhou Fei, Li Hui, et al (2018), "Disease characteristics and management of hospitalised adolescents and adults with community-acquired pneumonia in China: a retrospective multicentre survey", BMJ Open, 8(2), p.18709 Han X., Zhou F., Li H., et al (2018), "Effects of age, comorbidity and adherence to current antimicrobial guidelines on mortality in hospitalized elderly patients with communityacquired pneumonia", BMC Infect Dis, 18(1), p.192 10 National Institute for Health and Care Excellence "Pneumonia in adults: diagnosis and management",December2014.[Online].Available: https://www.nice.org.uk/guidance/cg191 [Accessed: June 21, 2019] 11 L A (2004), "Epidemiology and etiology of community-acquired pneumonia", Infectious disease clinics of North America, 18(4), pp.761-776 12 Mandell L A., Wunderink R G., Anzueto A., et al (2007), "Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults", Clinical infectious diseases: an official publication of the Infectious Diseases Society of America, 44(2), pp.S27-S72 13 Marston Hilary D, Dixon Dennis M, Knisely Jane M, et al (2016), "Antimicrobial resistance", JAMA, 316(11), pp.1193-1204 14 Matuz M., Bognar J., Hajdu E., et al (2015), "Treatment of Community-Acquired Pneumonia in Adults: Analysis of the National Dispensing Database", Basic & clinical pharmacology & toxicology, 117(5), pp.330-334 15 O'Doherty Jane, Leader Leonard F W., O'Regan Andrew, et al (2019), "Over prescribing of antibiotics for acute respiratory tract infections; a qualitative study to explore Irish general practitioners' perspectives", BMC family practice, 20(1), p.27 104 27/2020 16 Trinh H T., Hoang P H., Cardona-Morrell M., et al (2015), "Antibiotic therapy for inpatients with community-acquired pneumonia in a developing country", Pharmacoepidemiology and drug safety, 24(2), pp.129-136 17 Wunderink R G., Waterer G W (2014), "Clinical practice Community-acquired pneumonia", The New England journal of medicine, 370(6), pp.543-551 18 Zar H J., Madhi S A., Aston S J., et al (2013), "Pneumonia in low- and middle-income countries: progress and challenges", Thorax, 68(11), pp.1052-1056 (Ngày nh n bài: 2/ /2020 - Ngày K T QU B NH VI U TR UC C 19 / /2020) I TRÀNG TÁI PHÁT T I NH VI IH C -2019 1* Nguy 2, Ph B nh vi ng Nai ih cC n *Email: bs.nguyenvuonganh@gmail.com TÓM T T tv : i tràng m t b ng g p, x p th lo ng i tràng tái phát chi m t l kho ng 30-40% Vi c tái phát ph thu c vào nhi u y u t khác c u u nghiên c n y ut ng t u tr c ng vi n tiên ng b u tr sau tái phát.M c tiêu nghiên c u: nh m t s y u t n u tr i B nh vi uC nh vi ih cC t qu u tr nh u tr i B nh vi uC nh vi ih c C -4/2019 u: Nghiên c u mô t , ti n c u, theo dõi d c t t c b c ch u tr u tr t i B nh vi uC n nh vi n i h cC n 04/2019 K t qu : Qua kh o sát 30 b i tràng tái phát m t s y u t có ng t i tái phát th i gian s ng cịn khơng b n b nh theo WHO i u tr b i tràng tái phát t l ng v u tr 55,6%, y u t ng t i m ng s v trí tái phát (p=0,044) Các y u t kéo dài th i gian s ng không b nh ti n tri n c a b i tràng tái phát th i gian tái phát mu n (p=0,002), tái phát v ng hóa tr (p=0,046) K t lu n: Các b nh nhân n T3,T4, III có t l ng b n T1, T2, I, II S v trí tái phát ng t i m u tr Các y u t kéo dài th i gian s ng cịn khơng b nh ti n tri u tr c ng hóa tr , th i gian tái phát mu n T khóa: i tràng tái phát, y u t liên quan, k t qu u tr ABSTRACT EVALUATE OUTCOMES OF TREATMENT FOR RECURRENT COLON CANCER IN CAN THO CITY ONCOLOGY HOSPITAL AND CAN THO UNIVERSITY OF MEDICINE AND PHARMACY HOSPITAL IN 2017-2019 105 ... Pseudomonas l i có 18/70 c nh u tr v i kháng sinh có ph vi khu n bao ph - nh kháng sinh h c cách th n tr ph i h p kháng sinh - nh kháng sinh m pv p lý 103 27/2020 Kháng sinh -lactam B Y t (2015), -lactam... khác, [8] [16] Tuy cao [3] cy ut n vi c s d ng kh Vi c s d ng kháng sinh ph r ng tình tr ng c a BN c th hi n nghiên c u u tr v i kháng sinh có ph P aeruginosa , ch có 70 (29,8%) BN nh có YTNC m... - 13) ng - 25 ngày -lac 101 - 27/2020 c ph kh ng sinh kinh kháng sinh P aeruginosa l 63,8% cy ut n vi c s d ng kh T nh h p l v ch nh kh ng sinh kinh nghi m v sau c kh (n=235) nghi m s d ng,
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