Khóa luận tốt nghiệp ngành Dược: Khảo sát tính an toàn hợp lý của việc chỉ định kháng sinh trong điều trị ngoại trú nhiễm khuẩn hô hấp trên tại Bệnh viện Đại học Võ Trường Toản năm 2022

Khóa luận tốt nghiệp ngành Dược: Khảo sát tính an toàn hợp lý của việc chỉ định kháng sinh trong điều trị ngoại trú nhiễm khuẩn hô hấp trên tại Bệnh viện Đại học Võ Trường Toản năm 2022 được thực hiện với mục tiêu nhằm khảo sát thực trạng sử dụng thuốc kháng sinh an toàn – hợp lý trong điều trị nhiễm khuẩn hô hấp trên của bệnh... Đề tài Hoàn thiện công tác quản trị nhân sự tại Công ty TNHH Mộc Khải Tuyên được nghiên cứu nhằm giúp công ty TNHH Mộc Khải Tuyên làm rõ được thực trạng công tác quản trị nhân sự trong công ty như thế nào từ đó đề ra các giải pháp giúp công ty hoàn thiện công tác quản trị nhân sự tốt hơn trong thời gian tới.

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d154a 23f6b2 be48 d55b74c3677 f31a2 6752 77 Hậu Giang – 2022 33a8d66 6e7d7dc9e13 dd1 05b1 1d31 bb1a 3455 1df2b0 cb9 7186 bc6 d16a 369ee5 b ee72a4a6 c95e 8b44 261 c11b4da31 9ff705 b88da 47d8 4df733 b53a c07db5dfacc 1510e98 0f4 50b60aa5d5a6890 d04 084e1 69f91b0a 0746aa f8db6ad4b36 3cb2aa f7241 c66a 32f777 f8d7 cb0bb287 f89ee b3cc87 25aa013 8eb5 ef5 3e30 c2eaa3 b4 e02a5a6fa 70b0 7f7 fcd90 ba65b61b8 f12 3f1 9667 d8f652fe56 cf4 b7e8a dcc6c3 27fc8c5 9ff18a6 cc5 b550e f27 2207e 2890 e7004 6d87 71b5cc78 c4cc78 b7b5 3ed 7c671 77c6ed c0d9 cb4e3df6 d9b4 f27 9f2 4b01 e9147a 384db32 2798e 50c0f8e b6 be2c8 01b1fb0070 8e12 c6de 961 c5f1c0 06855 d27 b368 f5d3200 457bf86 82875 7da9aa76 fc2 ed63 f83 0eaf0 c38 74ebfb6 7e9c8ed f16 f6dc82 6b51 078e7 60f49c 65a914d4973 444e2 d79a7 58d43b2e 6adbb6da 6d7 cb1 d692 8950 8de5 27b9 8e614 08e5183 8cb468 07e5 f69d5b5 f32e 0b59 dd6 d94 9422a0 b5 cc7e 452e d3c3d3a4 8f c8c0 747 d2d9 988b26a4d181 f8d1ae03e7 8f6a 3d5a4 0036 f14 74f03bfa68a33 1f 24180d1943 19c5b53 60e51 00c27f5c0 6601 be5b55b9 1eb2 908e5 cb1a159e 6e2b bd19 f0b1a72 c4971 21fb1e8 ee703 c88 1d05 b4f370 b27a4 cb9a 76d3 8fc7fa3 9f9 6e4c1 25a430 5bfc91 dc8 7d41 6036 0fb00fca063 6038aae 4774 0cfd0a7 b33ab4d c075 cc2 f31a 7f7 245 c7a5fca8 f749 3b20 d1be27aa69 d40 c7a2 f7f36b3f0ae f35 e190ac1c9 6f6 f10 748 f84c4d3a 7aaad61 9ff8ef2 9806 c05 43c99b8a 20c9a1df4 b83b8 d125 48d1f8 da85e1 7f2 45c47e48 f5 cf18c4a38b4fb6219a 69980 133a2 49 BỘ GIÁO DỤC VÀ ĐÀO TẠO TRƯỜNG ĐẠI HỌC VÕ TRƯỜNG TOẢN NGUYỄN VIẾT KHÁNH KHẢO SÁT TÍNH AN TỒN – HỢP LÝ CỦA VIỆC CHỈ ĐỊNH KHÁNG SINH TRONG ĐIỀU TRỊ NGOẠI TRÚ NHIỄM KHUẨN HÔ HẤP TRÊN TẠI BỆNH VIỆN ĐẠI HỌC VÕ TRƯỜNG TOẢN NĂM 2022 6f87e 1b11a 932da b860 f81 b6 f9bdc3 2eca c777 6e0cf7 b60da 52f6cf66 b5ff294 1e747 e e1b11a9 32da b860 f81 b6f9bdc32 ecac7776 e0cf7b60da5 2f6 cf66b5ff2941e 747e 6f8 932dab860 f81b6f9 bdc32e cac7776e 0cf7b6 0da5 2f6 cf66b5ff2 941e 747e6 f87e 1b1 1a 860f8 1b6 f9bdc32eca c77 76e0 cf7 b60 da52 f6cf66 b5ff29 41e74 7e6f87e1 b11a9 32da b f81b6f9 bdc32e cac7 776e0 cf7b6 0da52 f6 cf6 6b5ff2 941e7 47e6 f87e 1b11a 932da b86 6f9bdc3 2eca c77 76e0 cf7 b60 da52 f6cf66 b5ff294 1e74 7e6f87e1 b11a9 32dab860 f81 b dc32e cac7776 e0cf7b60da5 2f6 cf66b5ff2941e 747e 6f87 e1b1 1a932 dab8 60f81b6 f9 b 32eca c7776 e0cf7 b60da 52f6cf66b5ff2941 e747e 6f8 7e1b11a932 dab8 60f81b6 f9 bdc c7776 e0cf7b60da 52f6 cf66b5ff2941 e747e 6f8 7e1b11a932 dab8 60f81b6 f9 bdc32e ca Chuyên ngành: Dược lý – Dược lâm sàng e0cf7b60 da52 f6 cf6 6b5ff2 941e7 47e6 f87e 1b11a 932da b860 f81 b6 f9bdc3 2eca c777 fc3a3 f93a 08582 6d66a 60f835 d2406 ea15 f7e7 b88cbf5e9cb78 cc9e16 d1072 e24 c3ee4 7d0800 c6a8 0136 f54 da448 1c2 b397 7f6 f33 e0be 8a4b3 d678 cc5b77 828 cc3 7ae38 f66a4 9c84a7 1dc1cb825a 4f1 d7c732fb9a4 e5765 f83 10c1984 f96 1e06 cf3 fc71f185b5ad74 b fac7b7b2 0dfcfdcdf1 cf4 2b2 fc6 b5a c1e9 c4a51ae fef5b7 de7f4b3 cc9e5d780d33d5 94 KHÓA LUẬN TỐT NGHIỆP ĐẠI HỌC DƯỢC 9e3f2 1bf4656 147e4 1c5 63d1 76a97 9e946 6be8 9c63 c0e 2907 0df0e654 8e28 c32 c6 f8f7 7ea8e433 c9 f051 8c9 06b9a 684d9d02 5cb598 854db148 3a8024 9bc348 7e1be 4646 2d7a b f21d145b5b08 b8e1 f8 c76 f42 b4ce 759fb93 c48 e7f8a41e7 8571e 64a2 f48b0e5 c8d4 bb8 df3 fa34df8 f2c9de ba5dcb1e e30bc7d67cb1d4163 72d9 47cdab0 1c5 76b2 b2efb3 c49a2 08d258 539 bc6 96d5a 3b1a4 c49 7180 bae30 dc4 4793a3 dc5d19 4ad09 3cb5c3f9 9f2 02398 Giảng viên hướng dẫn: 30ff2d29 b07 f39 d69e d7d2 e358bfca d25b40c5434 0e68a b4ee2 b76e0 b2a8 65300 be6e 95f4 fcb5fd1f4 934 f29e7 ee6d7cfa 31ddc0 5b49 f94 3c1 e22 f3b5 c0e4a d46 2e7c96fc5b ThS.DS TRẦN ĐỖ THANH PHONG ThS.DS.CKI HUỲNH HUY 3f9 f11 c9f0 8a6db91a1 7118e 3de6 3e7a02 f9 c1d19137 7d0a7a 34d40ff5b8 453 f6f4e0e 59e15a9 f853 8397 40b3 e9ac33e6fc51 7d8 b739 3a5076 c67 d16e 7cc03df1 b1f0b9 fc0 46 3a67e368 0a4d3d50 cf8d5 f476 8201 e328 cbbba50 c741 ebd4f6 b2e1 0316e d218 e1d2 918 0d4204 90efb3ab05fb73 c76 f04 f402 4609 30bbbd8c70 8725 e74dc8 cf9a 5b23 c6 ce52 6d 5a2ffad28c03f5ddc8 b5b1 9f6 5a9a4 f8ff22e 5e28b515a6 e2baff25 e0185 e7457 d94 b3 6e74e1a5 eb8e 6a6629 e94dc3 b8533 4599 8a334 c325 5d17 f25 1a9f0fc09d15d4 76fc381 14dd4 024 c2f27f32d2 1896e 863 d2798 93b4 5fb87d4d3 b709a d32bf1 f855 3822 14eb1 0a Hậu Giang – 2022 4a2b893 e6f264e6 3adfe30c144aa d9ad6 d154a 23f6b2 be48 d55b74c3677 f31a2 6752 77 33a8d66 6e7d7dc9e13 dd1 05b1 1d31 bb1a 3455 1df2b0 cb9 7186 bc6 d16a 369ee5 b ee72a4a6 c95e 8b44 261 c11b4da31 9ff705 b88da 47d8 4df733 b53a c07db5dfacc 1510e98 0f4 50b60aa5d5a6890 d04 084e1 69f91b0a 0746aa f8db6ad4b36 3cb2aa f7241 c66a 32f777 f8d7 cb0bb287 f89ee b3cc87 25aa013 8eb5 ef5 3e30 c2eaa3 b4 e02a5a6fa 70b0 7f7 fcd90 ba65b61b8 f12 3f1 9667 d8f652fe56 cf4 b7e8a dcc6c3 27fc8c5 9ff18a6 cc5 b550e f27 2207e 2890 e7004 6d87 71b5cc78 c4cc78 b7b5 3ed 7c671 77c6ed c0d9 cb4e3df6 d9b4 f27 9f2 4b01 e9147a 384db32 2798e 50c0f8e b6 be2c8 01b1fb0070 8e12 c6de 961 c5f1c0 06855 d27 b368 f5d3200 457bf86 82875 7da9aa76 fc2 ed63 f83 0eaf0 c38 74ebfb6 7e9c8ed f16 f6dc82 6b51 078e7 60f49c 65a914d4973 444e2 d79a7 58d43b2e 6adbb6da 6d7 cb1 d692 8950 8de5 27b9 8e614 08e5183 8cb468 07e5 f69d5b5 f32e 0b59 dd6 d94 9422a0 b5 cc7e 452e d3c3d3a4 8f c8c0 747 d2d9 988b26a4d181 f8d1ae03e7 8f6a 3d5a4 0036 f14 74f03bfa68a33 1f 24180d1943 19c5b53 60e51 00c27f5c0 6601 be5b55b9 1eb2 908e5 cb1a159e 6e2b bd19 f0b1a72 c4971 21fb1e8 ee703 c88 1d05 b4f370 b27a4 cb9a 76d3 8fc7fa3 9f9 6e4c1 25a430 5bfc91 dc8 7d41 6036 0fb00fca063 6038aae 4774 0cfd0a7 b33ab4d c075 cc2 f31a 7f7 245 c7a5fca8 f749 3b20 d1be27aa69 d40 c7a2 f7f36b3f0ae f35 e190ac1c9 6f6 f10 748 f84c4d3a 7aaad61 9ff8ef2 9806 c05 43c99b8a 20c9a1df4 b83b8 d125 48d1f8 da85e1 7f2 45c47e48 f5 cf18c4a38b4fb6219a 69980 133a2 49 LỜI CẢM ƠN Tơi xin bày toả lịng biết ơn sâu sắc tới ThS.DS Trần Đỗ Thanh Phong ThS.DS.CKI Huỳnh Huy người thầy trực tiếp hướng dẫn dành thời gian quý báo để dẫn tận tình cho tơi suốt thời gian thực Khố luận tốt nghiệp Tơi xin chân thành cảm ơn thầy cô Trường Đại học Võ Trường Toản trực tiếp giảng dạy truyền đạt cho kiến thức quý báo hành trình học tập trường Tơi xin trân trọng cảm ơn đến Ban giám đốc bác sĩ, dược sĩ công tác Bệnh viện Đại học Võ Trường Toản gúp đỡ tạo điều kiện thuận lợi cho tơi q trình thực Khố luận tốt nghiệp Trong thời gian thực Khoá luận tốt nghiệp, nhận động viên từ phía gia đình; giúp đỡ tận tình từ phía thầy cơ, anh chị bạn bè Tơi xin bày tỏ lòng biết ơn sâu sắc lời chúc thân thương đến tất người thân yêu giúp đỡ động viên Hậu Giang, ngày 09 tháng 07 năm 2022 Sinh viên 6f87e 1b11a 932da b860 f81 b6 f9bdc3 2eca c777 6e0cf7 b60da 52f6cf66 b5ff294 1e747 e e1b11a9 32da b860 f81 b6f9bdc32 ecac7776 e0cf7b60da5 2f6 cf66b5ff2941e 747e 6f8 932dab860 f81b6f9 bdc32e cac7776e 0cf7b6 0da5 2f6 cf66b5ff2 941e 747e6 f87e 1b1 1a 860f8 1b6 f9bdc32eca c77 76e0 cf7 b60 da52 f6cf66 b5ff29 41e74 7e6f87e1 b11a9 32da b f81b6f9 bdc32e cac7 776e0 cf7b6 0da52 f6 cf6 6b5ff2 941e7 47e6 f87e 1b11a 932da b86 6f9bdc3 2eca c77 76e0 cf7 b60 da52 f6cf66 b5ff294 1e74 7e6f87e1 b11a9 32dab860 f81 b dc32e cac7776 e0cf7b60da5 2f6 cf66b5ff2941e 747e 6f87 e1b1 1a932 dab8 60f81b6 f9 b 32eca c7776 e0cf7 b60da 52f6cf66b5ff2941 e747e 6f8 7e1b11a932 dab8 60f81b6 f9 bdc c7776 e0cf7b60da 52f6 cf66b5ff2941 e747e 6f8 7e1b11a932 dab8 60f81b6 f9 bdc32e ca e0cf7b60 da52 f6 cf6 6b5ff2 941e7 47e6 f87e 1b11a 932da b860 f81 b6 f9bdc3 2eca c777 Nguyễn Viết Khánh fc3a3 f93a 08582 6d66a 60f835 d2406 ea15 f7e7 b88cbf5e9cb78 cc9e16 d1072 e24 c3ee4 7d0800 c6a8 0136 f54 da448 1c2 b397 7f6 f33 e0be 8a4b3 d678 cc5b77 828 cc3 7ae38 f66a4 9c84a7 1dc1cb825a 4f1 d7c732fb9a4 e5765 f83 10c1984 f96 1e06 cf3 fc71f185b5ad74 b fac7b7b2 0dfcfdcdf1 cf4 2b2 fc6 b5a c1e9 c4a51ae fef5b7 de7f4b3 cc9e5d780d33d5 94 9e3f2 1bf4656 147e4 1c5 63d1 76a97 9e946 6be8 9c63 c0e 2907 0df0e654 8e28 c32 c6 f8f7 7ea8e433 c9 f051 8c9 06b9a 684d9d02 5cb598 854db148 3a8024 9bc348 7e1be 4646 2d7a b f21d145b5b08 b8e1 f8 c76 f42 b4ce 759fb93 c48 e7f8a41e7 8571e 64a2 f48b0e5 c8d4 bb8 df3 fa34df8 f2c9de ba5dcb1e e30bc7d67cb1d4163 72d9 47cdab0 1c5 76b2 b2efb3 c49a2 08d258 539 bc6 96d5a 3b1a4 c49 7180 bae30 dc4 4793a3 dc5d19 4ad09 3cb5c3f9 9f2 02398 30ff2d29 b07 f39 d69e d7d2 e358bfca d25b40c5434 0e68a b4ee2 b76e0 b2a8 65300 be6e 95f4 fcb5fd1f4 934 f29e7 ee6d7cfa 31ddc0 5b49 f94 3c1 e22 f3b5 c0e4a d46 2e7c96fc5b 3f9 f11 c9f0 8a6db91a1 7118e 3de6 3e7a02 f9 c1d19137 7d0a7a 34d40ff5b8 453 f6f4e0e 59e15a9 f853 8397 40b3 e9ac33e6fc51 7d8 b739 3a5076 c67 d16e 7cc03df1 b1f0b9 fc0 46 3a67e368 0a4d3d50 cf8d5 f476 8201 e328 cbbba50 c741 ebd4f6 b2e1 0316e d218 e1d2 918 0d4204 90efb3ab05fb73 c76 f04 f402 4609 30bbbd8c70 8725 e74dc8 cf9a 5b23 c6 ce52 6d 5a2ffad28c03f5ddc8 b5b1 9f6 5a9a4 f8ff22e 5e28b515a6 e2baff25 e0185 e7457 d94 b3 6e74e1a5 eb8e 6a6629 e94dc3 b8533 4599 8a334 c325 5d17 f25 1a9f0fc09d15d4 76fc381 14dd4 024 c2f27f32d2 1896e 863 d2798 93b4 5fb87d4d3 b709a d32bf1 f855 3822 14eb1 0a 4a2b893 e6f264e6 3adfe30c144aa d9ad6 d154a 23f6b2 be48 d55b74c3677 f31a2 6752 77 ii 33a8d66 6e7d7dc9e13 dd1 05b1 1d31 bb1a 3455 1df2b0 cb9 7186 bc6 d16a 369ee5 b ee72a4a6 c95e 8b44 261 c11b4da31 9ff705 b88da 47d8 4df733 b53a c07db5dfacc 1510e98 0f4 50b60aa5d5a6890 d04 084e1 69f91b0a 0746aa f8db6ad4b36 3cb2aa f7241 c66a 32f777 f8d7 cb0bb287 f89ee b3cc87 25aa013 8eb5 ef5 3e30 c2eaa3 b4 e02a5a6fa 70b0 7f7 fcd90 ba65b61b8 f12 3f1 9667 d8f652fe56 cf4 b7e8a dcc6c3 27fc8c5 9ff18a6 cc5 b550e f27 2207e 2890 e7004 6d87 71b5cc78 c4cc78 b7b5 3ed 7c671 77c6ed c0d9 cb4e3df6 d9b4 f27 9f2 4b01 e9147a 384db32 2798e 50c0f8e b6 be2c8 01b1fb0070 8e12 c6de 961 c5f1c0 06855 d27 b368 f5d3200 457bf86 82875 7da9aa76 fc2 ed63 f83 0eaf0 c38 74ebfb6 7e9c8ed f16 f6dc82 6b51 078e7 60f49c 65a914d4973 444e2 d79a7 58d43b2e 6adbb6da 6d7 cb1 d692 8950 8de5 27b9 8e614 08e5183 8cb468 07e5 f69d5b5 f32e 0b59 dd6 d94 9422a0 b5 cc7e 452e d3c3d3a4 8f c8c0 747 d2d9 988b26a4d181 f8d1ae03e7 8f6a 3d5a4 0036 f14 74f03bfa68a33 1f 24180d1943 19c5b53 60e51 00c27f5c0 6601 be5b55b9 1eb2 908e5 cb1a159e 6e2b bd19 f0b1a72 c4971 21fb1e8 ee703 c88 1d05 b4f370 b27a4 cb9a 76d3 8fc7fa3 9f9 6e4c1 25a430 5bfc91 dc8 7d41 6036 0fb00fca063 6038aae 4774 0cfd0a7 b33ab4d c075 cc2 f31a 7f7 245 c7a5fca8 f749 3b20 d1be27aa69 d40 c7a2 f7f36b3f0ae f35 e190ac1c9 6f6 f10 748 f84c4d3a 7aaad61 9ff8ef2 9806 c05 43c99b8a 20c9a1df4 b83b8 d125 48d1f8 da85e1 7f2 45c47e48 f5 cf18c4a38b4fb6219a 69980 133a2 49 LỜI CAM ĐOAN Tôi cam đoan cơng trình nghiên cứu tơi Các số liệu, kết nêu khóa luận trung thực chưa công bố cơng trình khác Sinh viên Nguyễn Viết Khánh 6f87e 1b11a 932da b860 f81 b6 f9bdc3 2eca c777 6e0cf7 b60da 52f6cf66 b5ff294 1e747 e e1b11a9 32da b860 f81 b6f9bdc32 ecac7776 e0cf7b60da5 2f6 cf66b5ff2941e 747e 6f8 932dab860 f81b6f9 bdc32e cac7776e 0cf7b6 0da5 2f6 cf66b5ff2 941e 747e6 f87e 1b1 1a 860f8 1b6 f9bdc32eca c77 76e0 cf7 b60 da52 f6cf66 b5ff29 41e74 7e6f87e1 b11a9 32da b f81b6f9 bdc32e cac7 776e0 cf7b6 0da52 f6 cf6 6b5ff2 941e7 47e6 f87e 1b11a 932da b86 6f9bdc3 2eca c77 76e0 cf7 b60 da52 f6cf66 b5ff294 1e74 7e6f87e1 b11a9 32dab860 f81 b dc32e cac7776 e0cf7b60da5 2f6 cf66b5ff2941e 747e 6f87 e1b1 1a932 dab8 60f81b6 f9 b 32eca c7776 e0cf7 b60da 52f6cf66b5ff2941 e747e 6f8 7e1b11a932 dab8 60f81b6 f9 bdc c7776 e0cf7b60da 52f6 cf66b5ff2941 e747e 6f8 7e1b11a932 dab8 60f81b6 f9 bdc32e ca e0cf7b60 da52 f6 cf6 6b5ff2 941e7 47e6 f87e 1b11a 932da b860 f81 b6 f9bdc3 2eca c777 fc3a3 f93a 08582 6d66a 60f835 d2406 ea15 f7e7 b88cbf5e9cb78 cc9e16 d1072 e24 c3ee4 7d0800 c6a8 0136 f54 da448 1c2 b397 7f6 f33 e0be 8a4b3 d678 cc5b77 828 cc3 7ae38 f66a4 9c84a7 1dc1cb825a 4f1 d7c732fb9a4 e5765 f83 10c1984 f96 1e06 cf3 fc71f185b5ad74 b fac7b7b2 0dfcfdcdf1 cf4 2b2 fc6 b5a c1e9 c4a51ae fef5b7 de7f4b3 cc9e5d780d33d5 94 9e3f2 1bf4656 147e4 1c5 63d1 76a97 9e946 6be8 9c63 c0e 2907 0df0e654 8e28 c32 c6 f8f7 7ea8e433 c9 f051 8c9 06b9a 684d9d02 5cb598 854db148 3a8024 9bc348 7e1be 4646 2d7a b f21d145b5b08 b8e1 f8 c76 f42 b4ce 759fb93 c48 e7f8a41e7 8571e 64a2 f48b0e5 c8d4 bb8 df3 fa34df8 f2c9de ba5dcb1e e30bc7d67cb1d4163 72d9 47cdab0 1c5 76b2 b2efb3 c49a2 08d258 539 bc6 96d5a 3b1a4 c49 7180 bae30 dc4 4793a3 dc5d19 4ad09 3cb5c3f9 9f2 02398 30ff2d29 b07 f39 d69e d7d2 e358bfca d25b40c5434 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932da b860 f81 b6 f9bdc3 2eca c777 fc3a3 f93a 08582 6d66a 60f835 d2406 ea15 f7e7 b88cbf5e9cb78 cc9e16 d1072 e24 c3ee4 7d0800 c6a8 0136 f54 da448 1c2 b397 7f6 f33 e0be 8a4b3 d678 cc5b77 828 cc3 7ae38 f66a4 9c84a7 1dc1cb825a 4f1 d7c732fb9a4 e5765 f83 10c1984 f96 1e06 cf3 fc71f185b5ad74 b fac7b7b2 0dfcfdcdf1 cf4 2b2 fc6 b5a c1e9 c4a51ae fef5b7 de7f4b3 cc9e5d780d33d5 94 9e3f2 1bf4656 147e4 1c5 63d1 76a97 9e946 6be8 9c63 c0e 2907 0df0e654 8e28 c32 c6 f8f7 7ea8e433 c9 f051 8c9 06b9a 684d9d02 5cb598 854db148 3a8024 9bc348 7e1be 4646 2d7a b f21d145b5b08 b8e1 f8 c76 f42 b4ce 759fb93 c48 e7f8a41e7 8571e 64a2 f48b0e5 c8d4 bb8 df3 fa34df8 f2c9de ba5dcb1e e30bc7d67cb1d4163 72d9 47cdab0 1c5 76b2 b2efb3 c49a2 08d258 539 bc6 96d5a 3b1a4 c49 7180 bae30 dc4 4793a3 dc5d19 4ad09 3cb5c3f9 9f2 02398 30ff2d29 b07 f39 d69e d7d2 e358bfca d25b40c5434 0e68a b4ee2 b76e0 b2a8 65300 be6e 95f4 fcb5fd1f4 934 f29e7 ee6d7cfa 31ddc0 5b49 f94 3c1 e22 f3b5 c0e4a d46 2e7c96fc5b 3f9 f11 c9f0 8a6db91a1 7118e 3de6 3e7a02 f9 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VIẾT TẮT Từ viết tắt Tiếng Anh Tiếng Việt AAP American Academy of Pediatrics Viện hàn lâm Nhi khoa Hoa Kỳ ABRS Acute bacterial rhinosinusitis Viêm mũi xoang cấp tính AOM Acute otitis media Viêm tai cấp AUC Area under the curve Diện tích đường cong C2G 2nd generation cephalosporins Cephalosporin hệ C3G 3rd generation cephalosporin Cephalosporin hệ CDC Centers for Disease Control and Trung tâm kiểm sốt phịng Prevention ngừa dịch bệnh Chronic obstructive pulmonary Bệnh phổi tắc nghẽn mạn tính COPD disease DNA Deoxyribonucleic Acid ESBL Extended-spectrum beta- b-lactamase phổ rộng lactamases FQ Fluoroquinolone Fluoroquinolon GABHS Group A Beta-hemolytic Streptococcus beta tan huyết 6f87e 1b11a 932da b860 f81 b6 f9bdc3 2eca c777 6e0cf7 b60da 52f6cf66 b5ff294 1e747 e e1b11a9 32da b860 f81 b6f9bdc32 ecac7776 e0cf7b60da5 2f6 cf66b5ff2941e 747e 6f8 932dab860 f81b6f9 bdc32e cac7776e 0cf7b6 0da5 2f6 cf66b5ff2 941e 747e6 f87e 1b1 1a 860f8 1b6 f9bdc32eca c77 76e0 cf7 b60 da52 f6cf66 b5ff29 41e74 7e6f87e1 b11a9 32da b f81b6f9 bdc32e cac7 776e0 cf7b6 0da52 f6 cf6 6b5ff2 941e7 47e6 f87e 1b11a 932da b86 IDSA streptococcus nhóm A Infectious Diseases Society of Hiệp hội bệnh truyền America nhiễm Hoa Kỳ 6f9bdc3 2eca c77 76e0 cf7 b60 da52 f6cf66 b5ff294 1e74 7e6f87e1 b11a9 32dab860 f81 b dc32e cac7776 e0cf7b60da5 2f6 cf66b5ff2941e 747e 6f87 e1b1 1a932 dab8 60f81b6 f9 b 32eca c7776 e0cf7 b60da 52f6cf66b5ff2941 e747e 6f8 7e1b11a932 dab8 60f81b6 f9 bdc c7776 e0cf7b60da 52f6 cf66b5ff2941 e747e 6f8 7e1b11a932 dab8 60f81b6 f9 bdc32e ca e0cf7b60 da52 f6 cf6 6b5ff2 941e7 47e6 f87e 1b11a 932da b860 f81 b6 f9bdc3 2eca c777 fc3a3 f93a 08582 6d66a 60f835 d2406 ea15 f7e7 b88cbf5e9cb78 cc9e16 d1072 e24 c3ee4 7d0800 c6a8 0136 f54 da448 1c2 b397 7f6 f33 e0be 8a4b3 d678 cc5b77 828 cc3 7ae38 f66a4 KS Kháng sinh KSĐ Kháng sinh đồ 9c84a7 1dc1cb825a 4f1 d7c732fb9a4 e5765 f83 10c1984 f96 1e06 cf3 fc71f185b5ad74 b fac7b7b2 0dfcfdcdf1 cf4 2b2 fc6 b5a c1e9 c4a51ae fef5b7 de7f4b3 cc9e5d780d33d5 94 9e3f2 1bf4656 147e4 1c5 63d1 76a97 9e946 6be8 9c63 c0e 2907 0df0e654 8e28 c32 c6 f8f7 7ea8e433 c9 f051 8c9 06b9a 684d9d02 5cb598 854db148 3a8024 9bc348 7e1be 4646 2d7a b f21d145b5b08 b8e1 f8 c76 f42 b4ce 759fb93 c48 e7f8a41e7 8571e 64a2 f48b0e5 c8d4 bb8 KSDP MIC Kháng sinh dự phòng Minimum Inhibitory Nồng độ ức chế tối thiểu df3 fa34df8 f2c9de ba5dcb1e e30bc7d67cb1d4163 72d9 47cdab0 1c5 76b2 b2efb3 c49a2 08d258 539 bc6 96d5a 3b1a4 c49 7180 bae30 dc4 4793a3 dc5d19 4ad09 3cb5c3f9 9f2 02398 30ff2d29 b07 f39 d69e d7d2 e358bfca d25b40c5434 0e68a b4ee2 b76e0 b2a8 65300 be6e 95f4 fcb5fd1f4 934 f29e7 ee6d7cfa 31ddc0 5b49 f94 3c1 e22 f3b5 c0e4a d46 2e7c96fc5b 3f9 f11 c9f0 8a6db91a1 7118e 3de6 3e7a02 f9 c1d19137 7d0a7a 34d40ff5b8 453 f6f4e0e Concentration 59e15a9 f853 8397 40b3 e9ac33e6fc51 7d8 b739 3a5076 c67 d16e 7cc03df1 b1f0b9 fc0 46 3a67e368 0a4d3d50 cf8d5 f476 8201 e328 cbbba50 c741 ebd4f6 b2e1 0316e d218 e1d2 918 MRSA Methicillin-resistant Tụ cầu vàng kháng methicillin 0d4204 90efb3ab05fb73 c76 f04 f402 4609 30bbbd8c70 8725 e74dc8 cf9a 5b23 c6 ce52 6d 5a2ffad28c03f5ddc8 b5b1 9f6 5a9a4 f8ff22e 5e28b515a6 e2baff25 e0185 e7457 d94 b3 6e74e1a5 eb8e 6a6629 e94dc3 b8533 4599 8a334 c325 5d17 f25 1a9f0fc09d15d4 76fc381 Staphylococcus aureus 14dd4 024 c2f27f32d2 1896e 863 d2798 93b4 5fb87d4d3 b709a d32bf1 f855 3822 14eb1 0a 4a2b893 e6f264e6 3adfe30c144aa d9ad6 d154a 23f6b2 be48 d55b74c3677 f31a2 6752 77 v 33a8d66 6e7d7dc9e13 dd1 05b1 1d31 bb1a 3455 1df2b0 cb9 7186 bc6 d16a 369ee5 b ee72a4a6 c95e 8b44 261 c11b4da31 9ff705 b88da 47d8 4df733 b53a c07db5dfacc 1510e98 0f4 50b60aa5d5a6890 d04 084e1 69f91b0a 0746aa f8db6ad4b36 3cb2aa f7241 c66a 32f777 f8d7 cb0bb287 f89ee b3cc87 25aa013 8eb5 ef5 3e30 c2eaa3 b4 e02a5a6fa 70b0 7f7 fcd90 ba65b61b8 f12 3f1 9667 d8f652fe56 cf4 b7e8a dcc6c3 27fc8c5 9ff18a6 cc5 b550e f27 2207e 2890 e7004 6d87 71b5cc78 c4cc78 b7b5 3ed 7c671 77c6ed c0d9 cb4e3df6 d9b4 f27 9f2 4b01 e9147a 384db32 2798e 50c0f8e b6 be2c8 01b1fb0070 8e12 c6de 961 c5f1c0 06855 d27 b368 f5d3200 457bf86 82875 7da9aa76 fc2 ed63 f83 0eaf0 c38 74ebfb6 7e9c8ed f16 f6dc82 6b51 078e7 60f49c 65a914d4973 444e2 d79a7 58d43b2e 6adbb6da 6d7 cb1 d692 8950 8de5 27b9 8e614 08e5183 8cb468 07e5 f69d5b5 f32e 0b59 dd6 d94 9422a0 b5 cc7e 452e d3c3d3a4 8f c8c0 747 d2d9 988b26a4d181 f8d1ae03e7 8f6a 3d5a4 0036 f14 74f03bfa68a33 1f 24180d1943 19c5b53 60e51 00c27f5c0 6601 be5b55b9 1eb2 908e5 cb1a159e 6e2b bd19 f0b1a72 c4971 21fb1e8 ee703 c88 1d05 b4f370 b27a4 cb9a 76d3 8fc7fa3 9f9 6e4c1 25a430 5bfc91 dc8 7d41 6036 0fb00fca063 6038aae 4774 0cfd0a7 b33ab4d c075 cc2 f31a 7f7 245 c7a5fca8 f749 3b20 d1be27aa69 d40 c7a2 f7f36b3f0ae f35 e190ac1c9 6f6 f10 748 f84c4d3a 7aaad61 9ff8ef2 9806 c05 43c99b8a 20c9a1df4 b83b8 d125 48d1f8 da85e1 7f2 45c47e48 f5 cf18c4a38b4fb6219a 69980 133a2 49 Từ viết tắt NICE Tiếng Anh Tiếng Việt National Institute for Health and Viện Y tế Chất lượng Điều Care Excellence trị Quốc gia Anh NKHHT Upper respiratory tract infections Nhiễm khuẩn hô hấp PAE Post Antibiotic Effect Tác dụng hậu kháng sinh PK/PD Pharmacokinetics/ Dược động học/ Dược lực học Pharmacodynamics RNA Ribonucleic Acid SARS-CoV-2 Severe acute respiratory syndrome Virus corona gây hội chứng hơ corona virus hấp cấp tính nặng TTM VRE Tiêm tĩnh mạch Vancomycin-Resistant Cầu khuẩn ruột kháng Enterococci vancomycin 6f87e 1b11a 932da b860 f81 b6 f9bdc3 2eca c777 6e0cf7 b60da 52f6cf66 b5ff294 1e747 e e1b11a9 32da b860 f81 b6f9bdc32 ecac7776 e0cf7b60da5 2f6 cf66b5ff2941e 747e 6f8 932dab860 f81b6f9 bdc32e cac7776e 0cf7b6 0da5 2f6 cf66b5ff2 941e 747e6 f87e 1b1 1a 860f8 1b6 f9bdc32eca c77 76e0 cf7 b60 da52 f6cf66 b5ff29 41e74 7e6f87e1 b11a9 32da b f81b6f9 bdc32e cac7 776e0 cf7b6 0da52 f6 cf6 6b5ff2 941e7 47e6 f87e 1b11a 932da b86 6f9bdc3 2eca c77 76e0 cf7 b60 da52 f6cf66 b5ff294 1e74 7e6f87e1 b11a9 32dab860 f81 b dc32e cac7776 e0cf7b60da5 2f6 cf66b5ff2941e 747e 6f87 e1b1 1a932 dab8 60f81b6 f9 b 32eca c7776 e0cf7 b60da 52f6cf66b5ff2941 e747e 6f8 7e1b11a932 dab8 60f81b6 f9 bdc c7776 e0cf7b60da 52f6 cf66b5ff2941 e747e 6f8 7e1b11a932 dab8 60f81b6 f9 bdc32e ca e0cf7b60 da52 f6 cf6 6b5ff2 941e7 47e6 f87e 1b11a 932da b860 f81 b6 f9bdc3 2eca c777 fc3a3 f93a 08582 6d66a 60f835 d2406 ea15 f7e7 b88cbf5e9cb78 cc9e16 d1072 e24 c3ee4 7d0800 c6a8 0136 f54 da448 1c2 b397 7f6 f33 e0be 8a4b3 d678 cc5b77 828 cc3 7ae38 f66a4 9c84a7 1dc1cb825a 4f1 d7c732fb9a4 e5765 f83 10c1984 f96 1e06 cf3 fc71f185b5ad74 b fac7b7b2 0dfcfdcdf1 cf4 2b2 fc6 b5a c1e9 c4a51ae fef5b7 de7f4b3 cc9e5d780d33d5 94 9e3f2 1bf4656 147e4 1c5 63d1 76a97 9e946 6be8 9c63 c0e 2907 0df0e654 8e28 c32 c6 f8f7 7ea8e433 c9 f051 8c9 06b9a 684d9d02 5cb598 854db148 3a8024 9bc348 7e1be 4646 2d7a b f21d145b5b08 b8e1 f8 c76 f42 b4ce 759fb93 c48 e7f8a41e7 8571e 64a2 f48b0e5 c8d4 bb8 df3 fa34df8 f2c9de ba5dcb1e e30bc7d67cb1d4163 72d9 47cdab0 1c5 76b2 b2efb3 c49a2 08d258 539 bc6 96d5a 3b1a4 c49 7180 bae30 dc4 4793a3 dc5d19 4ad09 3cb5c3f9 9f2 02398 30ff2d29 b07 f39 d69e d7d2 e358bfca d25b40c5434 0e68a b4ee2 b76e0 b2a8 65300 be6e 95f4 fcb5fd1f4 934 f29e7 ee6d7cfa 31ddc0 5b49 f94 3c1 e22 f3b5 c0e4a d46 2e7c96fc5b 3f9 f11 c9f0 8a6db91a1 7118e 3de6 3e7a02 f9 c1d19137 7d0a7a 34d40ff5b8 453 f6f4e0e 59e15a9 f853 8397 40b3 e9ac33e6fc51 7d8 b739 3a5076 c67 d16e 7cc03df1 b1f0b9 fc0 46 3a67e368 0a4d3d50 cf8d5 f476 8201 e328 cbbba50 c741 ebd4f6 b2e1 0316e d218 e1d2 918 0d4204 90efb3ab05fb73 c76 f04 f402 4609 30bbbd8c70 8725 e74dc8 cf9a 5b23 c6 ce52 6d 5a2ffad28c03f5ddc8 b5b1 9f6 5a9a4 f8ff22e 5e28b515a6 e2baff25 e0185 e7457 d94 b3 6e74e1a5 eb8e 6a6629 e94dc3 b8533 4599 8a334 c325 5d17 f25 1a9f0fc09d15d4 76fc381 14dd4 024 c2f27f32d2 1896e 863 d2798 93b4 5fb87d4d3 b709a d32bf1 f855 3822 14eb1 0a 4a2b893 e6f264e6 3adfe30c144aa d9ad6 d154a 23f6b2 be48 d55b74c3677 f31a2 6752 77 vi 33a8d66 6e7d7dc9e13 dd1 05b1 1d31 bb1a 3455 1df2b0 cb9 7186 bc6 d16a 369ee5 b ee72a4a6 c95e 8b44 261 c11b4da31 9ff705 b88da 47d8 4df733 b53a c07db5dfacc 1510e98 0f4 50b60aa5d5a6890 d04 084e1 69f91b0a 0746aa f8db6ad4b36 3cb2aa f7241 c66a 32f777 f8d7 cb0bb287 f89ee b3cc87 25aa013 8eb5 ef5 3e30 c2eaa3 b4 e02a5a6fa 70b0 7f7 fcd90 ba65b61b8 f12 3f1 9667 d8f652fe56 cf4 b7e8a dcc6c3 27fc8c5 9ff18a6 cc5 b550e f27 2207e 2890 e7004 6d87 71b5cc78 c4cc78 b7b5 3ed 7c671 77c6ed c0d9 cb4e3df6 d9b4 f27 9f2 4b01 e9147a 384db32 2798e 50c0f8e b6 be2c8 01b1fb0070 8e12 c6de 961 c5f1c0 06855 d27 b368 f5d3200 457bf86 82875 7da9aa76 fc2 ed63 f83 0eaf0 c38 74ebfb6 7e9c8ed f16 f6dc82 6b51 078e7 60f49c 65a914d4973 444e2 d79a7 58d43b2e 6adbb6da 6d7 cb1 d692 8950 8de5 27b9 8e614 08e5183 8cb468 07e5 f69d5b5 f32e 0b59 dd6 d94 9422a0 b5 cc7e 452e d3c3d3a4 8f c8c0 747 d2d9 988b26a4d181 f8d1ae03e7 8f6a 3d5a4 0036 f14 74f03bfa68a33 1f 24180d1943 19c5b53 60e51 00c27f5c0 6601 be5b55b9 1eb2 908e5 cb1a159e 6e2b bd19 f0b1a72 c4971 21fb1e8 ee703 c88 1d05 b4f370 b27a4 cb9a 76d3 8fc7fa3 9f9 6e4c1 25a430 5bfc91 dc8 7d41 6036 0fb00fca063 6038aae 4774 0cfd0a7 b33ab4d c075 cc2 f31a 7f7 245 c7a5fca8 f749 3b20 d1be27aa69 d40 c7a2 f7f36b3f0ae f35 e190ac1c9 6f6 f10 748 f84c4d3a 7aaad61 9ff8ef2 9806 c05 43c99b8a 20c9a1df4 b83b8 d125 48d1f8 da85e1 7f2 45c47e48 f5 cf18c4a38b4fb6219a 69980 133a2 49 MỤC LỤC LỜI CẢM ƠN ii LỜI CAM ĐOAN iii NHẬN XÉT CỦA GIÁO VIÊN HƯỚNG DẪN iv DANH MỤC TỪ VIẾT TẮT v MỤC LỤC vii DANH MỤC BẢNG x DANH MỤC BIỂU ĐỒ xii DANH MỤC HÌNH xiii ĐẶT VẤN ĐỀ MỤC TIÊU NGHIÊN CỨU CHƯƠNG TỔNG QUAN TÀI LIỆU 1.1 TỔNG QUAN VỀ KHÁNG SINH 1.1.1 Định nghĩa 1.1.2 Phân loại kháng sinh 1.1.3 Cơ chế tác động kháng sinh 1.2 ĐỀ KHÁNG KHÁNG SINH 6f87e 1b11a 932da b860 f81 b6 f9bdc3 2eca c777 6e0cf7 b60da 52f6cf66 b5ff294 1e747 e e1b11a9 32da b860 f81 b6f9bdc32 ecac7776 e0cf7b60da5 2f6 cf66b5ff2941e 747e 6f8 932dab860 f81b6f9 bdc32e cac7776e 0cf7b6 0da5 2f6 cf66b5ff2 941e 747e6 f87e 1b1 1a 860f8 1b6 f9bdc32eca c77 76e0 cf7 b60 da52 f6cf66 b5ff29 41e74 7e6f87e1 b11a9 32da b f81b6f9 bdc32e cac7 776e0 cf7b6 0da52 f6 cf6 6b5ff2 941e7 47e6 f87e 1b11a 932da b86 1.2.1 Tình hình đề kháng thuốc 1.2.2 Phân loại đề kháng kháng sinh 6f9bdc3 2eca c77 76e0 cf7 b60 da52 f6cf66 b5ff294 1e74 7e6f87e1 b11a9 32dab860 f81 b dc32e cac7776 e0cf7b60da5 2f6 cf66b5ff2941e 747e 6f87 e1b1 1a932 dab8 60f81b6 f9 b 32eca c7776 e0cf7 b60da 52f6cf66b5ff2941 e747e 6f8 7e1b11a932 dab8 60f81b6 f9 bdc c7776 e0cf7b60da 52f6 cf66b5ff2941 e747e 6f8 7e1b11a932 dab8 60f81b6 f9 bdc32e ca e0cf7b60 da52 f6 cf6 6b5ff2 941e7 47e6 f87e 1b11a 932da b860 f81 b6 f9bdc3 2eca c777 1.2.3 Cơ chế kháng kháng sinh vi khuẩn 10 fc3a3 f93a 08582 6d66a 60f835 d2406 ea15 f7e7 b88cbf5e9cb78 cc9e16 d1072 e24 c3ee4 7d0800 c6a8 0136 f54 da448 1c2 b397 7f6 f33 e0be 8a4b3 d678 cc5b77 828 cc3 7ae38 f66a4 1.2.4 Áp lực kháng sinh tổn hại phụ cận 11 1.3 NGUYÊN TẮC ĐIỀU TRỊ BẰNG KHÁNG SINH 12 9c84a7 1dc1cb825a 4f1 d7c732fb9a4 e5765 f83 10c1984 f96 1e06 cf3 fc71f185b5ad74 b fac7b7b2 0dfcfdcdf1 cf4 2b2 fc6 b5a c1e9 c4a51ae fef5b7 de7f4b3 cc9e5d780d33d5 94 9e3f2 1bf4656 147e4 1c5 63d1 76a97 9e946 6be8 9c63 c0e 2907 0df0e654 8e28 c32 c6 f8f7 7ea8e433 c9 f051 8c9 06b9a 684d9d02 5cb598 854db148 3a8024 9bc348 7e1be 4646 2d7a b f21d145b5b08 b8e1 f8 c76 f42 b4ce 759fb93 c48 e7f8a41e7 8571e 64a2 f48b0e5 c8d4 bb8 1.3.1 Lựa chọn kháng sinh hợp lý 12 1.3.2 Nguyên tắc chung điều trị kháng sinh 12 df3 fa34df8 f2c9de ba5dcb1e e30bc7d67cb1d4163 72d9 47cdab0 1c5 76b2 b2efb3 c49a2 08d258 539 bc6 96d5a 3b1a4 c49 7180 bae30 dc4 4793a3 dc5d19 4ad09 3cb5c3f9 9f2 02398 30ff2d29 b07 f39 d69e d7d2 e358bfca d25b40c5434 0e68a b4ee2 b76e0 b2a8 65300 be6e 95f4 fcb5fd1f4 934 f29e7 ee6d7cfa 31ddc0 5b49 f94 3c1 e22 f3b5 c0e4a d46 2e7c96fc5b 3f9 f11 c9f0 8a6db91a1 7118e 3de6 3e7a02 f9 c1d19137 7d0a7a 34d40ff5b8 453 f6f4e0e 1.4 QUẢN LÝ KÊ TOA KHÁNG SINH NGOẠI TRÚ 13 59e15a9 f853 8397 40b3 e9ac33e6fc51 7d8 b739 3a5076 c67 d16e 7cc03df1 b1f0b9 fc0 46 3a67e368 0a4d3d50 cf8d5 f476 8201 e328 cbbba50 c741 ebd4f6 b2e1 0316e d218 e1d2 918 1.5 KHÁNG SINH TRONG ĐIỀU TRỊ NHIỄM KHUẨN HÔ HẤP TRÊN 14 0d4204 90efb3ab05fb73 c76 f04 f402 4609 30bbbd8c70 8725 e74dc8 cf9a 5b23 c6 ce52 6d 5a2ffad28c03f5ddc8 b5b1 9f6 5a9a4 f8ff22e 5e28b515a6 e2baff25 e0185 e7457 d94 b3 6e74e1a5 eb8e 6a6629 e94dc3 b8533 4599 8a334 c325 5d17 f25 1a9f0fc09d15d4 76fc381 1.5.1 Viêm mũi họng cấp (cảm thường) 14 14dd4 024 c2f27f32d2 1896e 863 d2798 93b4 5fb87d4d3 b709a d32bf1 f855 3822 14eb1 0a 4a2b893 e6f264e6 3adfe30c144aa d9ad6 d154a 23f6b2 be48 d55b74c3677 f31a2 6752 77 1.5.2 Viêm họng cấp (Acute pharyngitis) 15 vii 33a8d66 6e7d7dc9e13 dd1 05b1 1d31 bb1a 3455 1df2b0 cb9 7186 bc6 d16a 369ee5 b ee72a4a6 c95e 8b44 261 c11b4da31 9ff705 b88da 47d8 4df733 b53a c07db5dfacc 1510e98 0f4 50b60aa5d5a6890 d04 084e1 69f91b0a 0746aa f8db6ad4b36 3cb2aa f7241 c66a 32f777 f8d7 cb0bb287 f89ee b3cc87 25aa013 8eb5 ef5 3e30 c2eaa3 b4 e02a5a6fa 70b0 7f7 fcd90 ba65b61b8 f12 3f1 9667 d8f652fe56 cf4 b7e8a dcc6c3 27fc8c5 9ff18a6 cc5 b550e f27 2207e 2890 e7004 6d87 71b5cc78 c4cc78 b7b5 3ed 7c671 77c6ed c0d9 cb4e3df6 d9b4 f27 9f2 4b01 e9147a 384db32 2798e 50c0f8e b6 be2c8 01b1fb0070 8e12 c6de 961 c5f1c0 06855 d27 b368 f5d3200 457bf86 82875 7da9aa76 fc2 ed63 f83 0eaf0 c38 74ebfb6 7e9c8ed f16 f6dc82 6b51 078e7 60f49c 65a914d4973 444e2 d79a7 58d43b2e 6adbb6da 6d7 cb1 d692 8950 8de5 27b9 8e614 08e5183 8cb468 07e5 f69d5b5 f32e 0b59 dd6 d94 9422a0 b5 cc7e 452e d3c3d3a4 8f c8c0 747 d2d9 988b26a4d181 f8d1ae03e7 8f6a 3d5a4 0036 f14 74f03bfa68a33 1f 24180d1943 19c5b53 60e51 00c27f5c0 6601 be5b55b9 1eb2 908e5 cb1a159e 6e2b bd19 f0b1a72 c4971 21fb1e8 ee703 c88 1d05 b4f370 b27a4 cb9a 76d3 8fc7fa3 9f9 6e4c1 25a430 5bfc91 dc8 7d41 6036 0fb00fca063 6038aae 4774 0cfd0a7 b33ab4d c075 cc2 f31a 7f7 245 c7a5fca8 f749 3b20 d1be27aa69 d40 c7a2 f7f36b3f0ae f35 e190ac1c9 6f6 f10 748 f84c4d3a 7aaad61 9ff8ef2 9806 c05 43c99b8a 20c9a1df4 b83b8 d125 48d1f8 da85e1 7f2 45c47e48 f5 cf18c4a38b4fb6219a 69980 133a2 49 1.5.3 Viêm mũi xoang cấp tính (Acute bacterial rhinosinusitis) 17 1.5.4 Viêm tai cấp (Acute otitis media) 20 1.6 NGHIÊN CỨU TRONG VÀ NGOÀI NƯỚC LIÊN QUAN ĐẾN SỬ DỤNG KHÁNG SINH AN TOÀN – HỢP LÝ 22 CHƯƠNG ĐỐI TƯỢNG VÀ PHƯƠNG PHÁP NGHIÊN CỨU 26 2.1 ĐỐI TƯỢNG NGHIÊN CỨU 26 2.1.1 Tiêu chuẩn chọn mẫu 26 2.1.2 Tiêu chuẩn loại trừ 26 2.1.3 Địa điểm thời gian nghiên cứu 26 2.2 PHƯƠNG PHÁP NGHIÊN CỨU 26 2.2.1 Thiết kế nghiên cứu 26 2.2.2 Cỡ mẫu 26 2.2.3 Phương pháp quy trình chọn mẫu 27 2.2.4 Nội dung nghiên cứu 27 2.2.5 Phương pháp xử lý phân tích số liệu 36 2.2.6 Phương pháp hạn chế sai số 37 2.3 ĐẠO ĐỨC NGHIÊN CỨU 37 CHƯƠNG KẾT QUẢ NGHIÊN CỨU 38 6f87e 1b11a 932da b860 f81 b6 f9bdc3 2eca c777 6e0cf7 b60da 52f6cf66 b5ff294 1e747 e e1b11a9 32da b860 f81 b6f9bdc32 ecac7776 e0cf7b60da5 2f6 cf66b5ff2941e 747e 6f8 932dab860 f81b6f9 bdc32e cac7776e 0cf7b6 0da5 2f6 cf66b5ff2 941e 747e6 f87e 1b1 1a 860f8 1b6 f9bdc32eca c77 76e0 cf7 b60 da52 f6cf66 b5ff29 41e74 7e6f87e1 b11a9 32da b f81b6f9 bdc32e cac7 776e0 cf7b6 0da52 f6 cf6 6b5ff2 941e7 47e6 f87e 1b11a 932da b86 3.1 KHẢO SÁT THỰC TRẠNG SỬ DỤNG THUỐC KHÁNG SINH TRONG 6f9bdc3 2eca c77 76e0 cf7 b60 da52 f6cf66 b5ff294 1e74 7e6f87e1 b11a9 32dab860 f81 b dc32e cac7776 e0cf7b60da5 2f6 cf66b5ff2941e 747e 6f87 e1b1 1a932 dab8 60f81b6 f9 b MẪU NGHIÊN CỨU 38 3.1.1 Đặc điểm chung bệnh nhân mẫu nghiên cứu 38 32eca c7776 e0cf7 b60da 52f6cf66b5ff2941 e747e 6f8 7e1b11a932 dab8 60f81b6 f9 bdc c7776 e0cf7b60da 52f6 cf66b5ff2941 e747e 6f8 7e1b11a932 dab8 60f81b6 f9 bdc32e ca e0cf7b60 da52 f6 cf6 6b5ff2 941e7 47e6 f87e 1b11a 932da b860 f81 b6 f9bdc3 2eca c777 fc3a3 f93a 08582 6d66a 60f835 d2406 ea15 f7e7 b88cbf5e9cb78 cc9e16 d1072 e24 c3ee4 7d0800 c6a8 0136 f54 da448 1c2 b397 7f6 f33 e0be 8a4b3 d678 cc5b77 828 cc3 7ae38 f66a4 3.1.2 Đặc điểm thuốc điều trị mẫu nghiên cứu 41 3.1.3 Khảo sát tính an toàn – hợp lý việc định kháng sinh mẫu 9c84a7 1dc1cb825a 4f1 d7c732fb9a4 e5765 f83 10c1984 f96 1e06 cf3 fc71f185b5ad74 b fac7b7b2 0dfcfdcdf1 cf4 2b2 fc6 b5a c1e9 c4a51ae fef5b7 de7f4b3 cc9e5d780d33d5 94 9e3f2 1bf4656 147e4 1c5 63d1 76a97 9e946 6be8 9c63 c0e 2907 0df0e654 8e28 c32 c6 f8f7 7ea8e433 c9 f051 8c9 06b9a 684d9d02 5cb598 854db148 3a8024 9bc348 7e1be 4646 2d7a b f21d145b5b08 b8e1 f8 c76 f42 b4ce 759fb93 c48 e7f8a41e7 8571e 64a2 f48b0e5 c8d4 bb8 nghiên cứu 47 df3 fa34df8 f2c9de ba5dcb1e e30bc7d67cb1d4163 72d9 47cdab0 1c5 76b2 b2efb3 c49a2 08d258 539 bc6 96d5a 3b1a4 c49 7180 bae30 dc4 4793a3 dc5d19 4ad09 3cb5c3f9 9f2 02398 3.1.4 Khảo sát tương tác thuốc kháng sinh mẫu nghiên cứu 52 30ff2d29 b07 f39 d69e d7d2 e358bfca d25b40c5434 0e68a b4ee2 b76e0 b2a8 65300 be6e 95f4 fcb5fd1f4 934 f29e7 ee6d7cfa 31ddc0 5b49 f94 3c1 e22 f3b5 c0e4a d46 2e7c96fc5b 3f9 f11 c9f0 8a6db91a1 7118e 3de6 3e7a02 f9 c1d19137 7d0a7a 34d40ff5b8 453 f6f4e0e 3.2 YẾU TỐ LIÊN QUAN ĐẾN SỬ DỤNG KHÁNG SINH KHÔNG AN TOÀN 59e15a9 f853 8397 40b3 e9ac33e6fc51 7d8 b739 3a5076 c67 d16e 7cc03df1 b1f0b9 fc0 46 3a67e368 0a4d3d50 cf8d5 f476 8201 e328 cbbba50 c741 ebd4f6 b2e1 0316e d218 e1d2 918 – HỢP LÝ TRONG MẪU NGHIÊN CỨU 55 3.2.1 Giới tính bệnh nhân 55 0d4204 90efb3ab05fb73 c76 f04 f402 4609 30bbbd8c70 8725 e74dc8 cf9a 5b23 c6 ce52 6d 5a2ffad28c03f5ddc8 b5b1 9f6 5a9a4 f8ff22e 5e28b515a6 e2baff25 e0185 e7457 d94 b3 6e74e1a5 eb8e 6a6629 e94dc3 b8533 4599 8a334 c325 5d17 f25 1a9f0fc09d15d4 76fc381 14dd4 024 c2f27f32d2 1896e 863 d2798 93b4 5fb87d4d3 b709a d32bf1 f855 3822 14eb1 0a 4a2b893 e6f264e6 3adfe30c144aa d9ad6 d154a 23f6b2 be48 d55b74c3677 f31a2 6752 77 3.2.2 Tuổi bệnh nhân 56 viii 33a8d66 6e7d7dc9e13 dd1 05b1 1d31 bb1a 3455 1df2b0 cb9 7186 bc6 d16a 369ee5 b ee72a4a6 c95e 8b44 261 c11b4da31 9ff705 b88da 47d8 4df733 b53a c07db5dfacc 1510e98 0f4 50b60aa5d5a6890 d04 084e1 69f91b0a 0746aa f8db6ad4b36 3cb2aa f7241 c66a 32f777 f8d7 cb0bb287 f89ee b3cc87 25aa013 8eb5 ef5 3e30 c2eaa3 b4 e02a5a6fa 70b0 7f7 fcd90 ba65b61b8 f12 3f1 9667 d8f652fe56 cf4 b7e8a dcc6c3 27fc8c5 9ff18a6 cc5 b550e f27 2207e 2890 e7004 6d87 71b5cc78 c4cc78 b7b5 3ed 7c671 77c6ed c0d9 cb4e3df6 d9b4 f27 9f2 4b01 e9147a 384db32 2798e 50c0f8e b6 be2c8 01b1fb0070 8e12 c6de 961 c5f1c0 06855 d27 b368 f5d3200 457bf86 82875 7da9aa76 fc2 ed63 f83 0eaf0 c38 74ebfb6 7e9c8ed f16 f6dc82 6b51 078e7 60f49c 65a914d4973 444e2 d79a7 58d43b2e 6adbb6da 6d7 cb1 d692 8950 8de5 27b9 8e614 08e5183 8cb468 07e5 f69d5b5 f32e 0b59 dd6 d94 9422a0 b5 cc7e 452e d3c3d3a4 8f c8c0 747 d2d9 988b26a4d181 f8d1ae03e7 8f6a 3d5a4 0036 f14 74f03bfa68a33 1f 24180d1943 19c5b53 60e51 00c27f5c0 6601 be5b55b9 1eb2 908e5 cb1a159e 6e2b bd19 f0b1a72 c4971 21fb1e8 ee703 c88 1d05 b4f370 b27a4 cb9a 76d3 8fc7fa3 9f9 6e4c1 25a430 5bfc91 dc8 7d41 6036 0fb00fca063 6038aae 4774 0cfd0a7 b33ab4d c075 cc2 f31a 7f7 245 c7a5fca8 f749 3b20 d1be27aa69 d40 c7a2 f7f36b3f0ae f35 e190ac1c9 6f6 f10 748 f84c4d3a 7aaad61 9ff8ef2 9806 c05 43c99b8a 20c9a1df4 b83b8 d125 48d1f8 da85e1 7f2 45c47e48 f5 cf18c4a38b4fb6219a 69980 133a2 49 3.2.3 Bệnh nhân tái khám 57 3.2.4 Bệnh kèm theo 57 3.2.5 Phối hợp kháng sinh 58 3.2.6 Tương tác kháng sinh 59 CHƯƠNG BÀN LUẬN 60 4.1 KHẢO SÁT THỰC TRẠNG SỬ DỤNG THUỐC KHÁNG SINH TRONG MẪU NGHIÊN CỨU 60 4.1.1 Đặc điểm chung bệnh nhân mẫu nghiên cứu 60 4.1.2 Đặc điểm thuốc điều trị mẫu nghiên cứu 62 4.1.3 Khảo sát tính an tồn – hợp lý việc định kháng sinh mẫu nghiên cứu 68 4.1.4 Khảo sát tương tác thuốc kháng sinh mẫu nghiên cứu 72 4.2 YẾU TỐ LIÊN QUAN ĐẾN SỬ DỤNG KHÁNG SINH KHƠNG AN TỒN – HỢP LÝ TRONG MẪU NGHIÊN CỨU 73 4.3 HẠN CHẾ CỦA NGHIÊN CỨU 75 KẾT LUẬN 77 KIẾN NGHỊ 79 TÀI LIỆU THAM KHẢO 6f87e 1b11a 932da b860 f81 b6 f9bdc3 2eca c777 6e0cf7 b60da 52f6cf66 b5ff294 1e747 e e1b11a9 32da b860 f81 b6f9bdc32 ecac7776 e0cf7b60da5 2f6 cf66b5ff2941e 747e 6f8 932dab860 f81b6f9 bdc32e cac7776e 0cf7b6 0da5 2f6 cf66b5ff2 941e 747e6 f87e 1b1 1a 860f8 1b6 f9bdc32eca c77 76e0 cf7 b60 da52 f6cf66 b5ff29 41e74 7e6f87e1 b11a9 32da b f81b6f9 bdc32e cac7 776e0 cf7b6 0da52 f6 cf6 6b5ff2 941e7 47e6 f87e 1b11a 932da b86 PHỤ LỤC 6f9bdc3 2eca c77 76e0 cf7 b60 da52 f6cf66 b5ff294 1e74 7e6f87e1 b11a9 32dab860 f81 b dc32e cac7776 e0cf7b60da5 2f6 cf66b5ff2941e 747e 6f87 e1b1 1a932 dab8 60f81b6 f9 b 32eca c7776 e0cf7 b60da 52f6cf66b5ff2941 e747e 6f8 7e1b11a932 dab8 60f81b6 f9 bdc c7776 e0cf7b60da 52f6 cf66b5ff2941 e747e 6f8 7e1b11a932 dab8 60f81b6 f9 bdc32e ca e0cf7b60 da52 f6 cf6 6b5ff2 941e7 47e6 f87e 1b11a 932da b860 f81 b6 f9bdc3 2eca c777 fc3a3 f93a 08582 6d66a 60f835 d2406 ea15 f7e7 b88cbf5e9cb78 cc9e16 d1072 e24 c3ee4 7d0800 c6a8 0136 f54 da448 1c2 b397 7f6 f33 e0be 8a4b3 d678 cc5b77 828 cc3 7ae38 f66a4 9c84a7 1dc1cb825a 4f1 d7c732fb9a4 e5765 f83 10c1984 f96 1e06 cf3 fc71f185b5ad74 b fac7b7b2 0dfcfdcdf1 cf4 2b2 fc6 b5a c1e9 c4a51ae fef5b7 de7f4b3 cc9e5d780d33d5 94 9e3f2 1bf4656 147e4 1c5 63d1 76a97 9e946 6be8 9c63 c0e 2907 0df0e654 8e28 c32 c6 f8f7 7ea8e433 c9 f051 8c9 06b9a 684d9d02 5cb598 854db148 3a8024 9bc348 7e1be 4646 2d7a b f21d145b5b08 b8e1 f8 c76 f42 b4ce 759fb93 c48 e7f8a41e7 8571e 64a2 f48b0e5 c8d4 bb8 df3 fa34df8 f2c9de ba5dcb1e e30bc7d67cb1d4163 72d9 47cdab0 1c5 76b2 b2efb3 c49a2 08d258 539 bc6 96d5a 3b1a4 c49 7180 bae30 dc4 4793a3 dc5d19 4ad09 3cb5c3f9 9f2 02398 30ff2d29 b07 f39 d69e d7d2 e358bfca d25b40c5434 0e68a b4ee2 b76e0 b2a8 65300 be6e 95f4 fcb5fd1f4 934 f29e7 ee6d7cfa 31ddc0 5b49 f94 3c1 e22 f3b5 c0e4a d46 2e7c96fc5b 3f9 f11 c9f0 8a6db91a1 7118e 3de6 3e7a02 f9 c1d19137 7d0a7a 34d40ff5b8 453 f6f4e0e 59e15a9 f853 8397 40b3 e9ac33e6fc51 7d8 b739 3a5076 c67 d16e 7cc03df1 b1f0b9 fc0 46 3a67e368 0a4d3d50 cf8d5 f476 8201 e328 cbbba50 c741 ebd4f6 b2e1 0316e d218 e1d2 918 0d4204 90efb3ab05fb73 c76 f04 f402 4609 30bbbd8c70 8725 e74dc8 cf9a 5b23 c6 ce52 6d 5a2ffad28c03f5ddc8 b5b1 9f6 5a9a4 f8ff22e 5e28b515a6 e2baff25 e0185 e7457 d94 b3 6e74e1a5 eb8e 6a6629 e94dc3 b8533 4599 8a334 c325 5d17 f25 1a9f0fc09d15d4 76fc381 14dd4 024 c2f27f32d2 1896e 863 d2798 93b4 5fb87d4d3 b709a d32bf1 f855 3822 14eb1 0a 4a2b893 e6f264e6 3adfe30c144aa d9ad6 d154a 23f6b2 be48 d55b74c3677 f31a2 6752 77 ix 33a8d66 6e7d7dc9e13 dd1 05b1 1d31 bb1a 3455 1df2b0 cb9 7186 bc6 d16a 369ee5 b ee72a4a6 c95e 8b44 261 c11b4da31 9ff705 b88da 47d8 4df733 b53a c07db5dfacc 1510e98 0f4 50b60aa5d5a6890 d04 084e1 69f91b0a 0746aa f8db6ad4b36 3cb2aa f7241 c66a 32f777 f8d7 cb0bb287 f89ee b3cc87 25aa013 8eb5 ef5 3e30 c2eaa3 b4 e02a5a6fa 70b0 7f7 fcd90 ba65b61b8 f12 3f1 9667 d8f652fe56 cf4 b7e8a dcc6c3 27fc8c5 9ff18a6 cc5 b550e f27 2207e 2890 e7004 6d87 71b5cc78 c4cc78 b7b5 3ed 7c671 77c6ed c0d9 cb4e3df6 d9b4 f27 9f2 4b01 e9147a 384db32 2798e 50c0f8e b6 be2c8 01b1fb0070 8e12 c6de 961 c5f1c0 06855 d27 b368 f5d3200 457bf86 82875 7da9aa76 fc2 ed63 f83 0eaf0 c38 74ebfb6 7e9c8ed f16 f6dc82 6b51 078e7 60f49c 65a914d4973 444e2 d79a7 58d43b2e 6adbb6da 6d7 cb1 d692 8950 8de5 27b9 8e614 08e5183 8cb468 07e5 f69d5b5 f32e 0b59 dd6 d94 9422a0 b5 cc7e 452e d3c3d3a4 8f c8c0 747 d2d9 988b26a4d181 f8d1ae03e7 8f6a 3d5a4 0036 f14 74f03bfa68a33 1f 24180d1943 19c5b53 60e51 00c27f5c0 6601 be5b55b9 1eb2 908e5 cb1a159e 6e2b bd19 f0b1a72 c4971 21fb1e8 ee703 c88 1d05 b4f370 b27a4 cb9a 76d3 8fc7fa3 9f9 6e4c1 25a430 5bfc91 dc8 7d41 6036 0fb00fca063 6038aae 4774 0cfd0a7 b33ab4d c075 cc2 f31a 7f7 245 c7a5fca8 f749 3b20 d1be27aa69 d40 c7a2 f7f36b3f0ae f35 e190ac1c9 6f6 f10 748 f84c4d3a 7aaad61 9ff8ef2 9806 c05 43c99b8a 20c9a1df4 b83b8 d125 48d1f8 da85e1 7f2 45c47e48 f5 cf18c4a38b4fb6219a 69980 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Wu YQ., et al (2014), "[Utilization of antibacterial agents for emergency 6f87e 1b11a 932da b860 f81 b6 f9bdc3 2eca c777 6e0cf7 b60da 52f6cf66 b5ff294 1e747 e e1b11a9 32da b860 f81 b6f9bdc32 ecac7776 e0cf7b60da5 2f6 cf66b5ff2941e 747e 6f8 932dab860 f81b6f9 bdc32e cac7776e 0cf7b6 0da5 2f6 cf66b5ff2 941e 747e6 f87e 1b1 1a 860f8 1b6 f9bdc32eca c77 76e0 cf7 b60 da52 f6cf66 b5ff29 41e74 7e6f87e1 b11a9 32da b f81b6f9 bdc32e cac7 776e0 cf7b6 0da52 f6 cf6 6b5ff2 941e7 47e6 f87e 1b11a 932da b86 patients with acute upper respiratory infections in tertiary hospitals in Beijing]", 6f9bdc3 2eca c77 76e0 cf7 b60 da52 f6cf66 b5ff294 1e74 7e6f87e1 b11a9 32dab860 f81 b dc32e cac7776 e0cf7b60da5 2f6 cf66b5ff2941e 747e 6f87 e1b1 1a932 dab8 60f81b6 f9 b Beijing Da Xue Xue Bao Yi Xue Ban 46(3), pp 435-9 80 Xue F., et al (2021), "Antibiotic prescriptions for children younger than years 32eca c7776 e0cf7 b60da 52f6cf66b5ff2941 e747e 6f8 7e1b11a932 dab8 60f81b6 f9 bdc c7776 e0cf7b60da 52f6 cf66b5ff2941 e747e 6f8 7e1b11a932 dab8 60f81b6 f9 bdc32e ca e0cf7b60 da52 f6 cf6 6b5ff2 941e7 47e6 f87e 1b11a 932da b860 f81 b6 f9bdc3 2eca c777 fc3a3 f93a 08582 6d66a 60f835 d2406 ea15 f7e7 b88cbf5e9cb78 cc9e16 d1072 e24 c3ee4 7d0800 c6a8 0136 f54 da448 1c2 b397 7f6 f33 e0be 8a4b3 d678 cc5b77 828 cc3 7ae38 f66a4 with acute upper respiratory infections in China: a retrospective nationwide claims database study", BMC Infect Dis 21(1), p 339 9c84a7 1dc1cb825a 4f1 d7c732fb9a4 e5765 f83 10c1984 f96 1e06 cf3 fc71f185b5ad74 b fac7b7b2 0dfcfdcdf1 cf4 2b2 fc6 b5a c1e9 c4a51ae fef5b7 de7f4b3 cc9e5d780d33d5 94 9e3f2 1bf4656 147e4 1c5 63d1 76a97 9e946 6be8 9c63 c0e 2907 0df0e654 8e28 c32 c6 f8f7 7ea8e433 c9 f051 8c9 06b9a 684d9d02 5cb598 854db148 3a8024 9bc348 7e1be 4646 2d7a b f21d145b5b08 b8e1 f8 c76 f42 b4ce 759fb93 c48 e7f8a41e7 8571e 64a2 f48b0e5 c8d4 bb8 81 Zhao H., et al (2020), "Outpatient antibiotic use associated with acute upper df3 fa34df8 f2c9de ba5dcb1e e30bc7d67cb1d4163 72d9 47cdab0 1c5 76b2 b2efb3 c49a2 08d258 539 bc6 96d5a 3b1a4 c49 7180 bae30 dc4 4793a3 dc5d19 4ad09 3cb5c3f9 9f2 02398 respiratory infections in China: a nationwide cross-sectional study", Int J 30ff2d29 b07 f39 d69e d7d2 e358bfca d25b40c5434 0e68a b4ee2 b76e0 b2a8 65300 be6e 95f4 fcb5fd1f4 934 f29e7 ee6d7cfa 31ddc0 5b49 f94 3c1 e22 f3b5 c0e4a d46 2e7c96fc5b 3f9 f11 c9f0 8a6db91a1 7118e 3de6 3e7a02 f9 c1d19137 7d0a7a 34d40ff5b8 453 f6f4e0e Antimicrob Agents 56(6), p 106193 59e15a9 f853 8397 40b3 e9ac33e6fc51 7d8 b739 3a5076 c67 d16e 7cc03df1 b1f0b9 fc0 46 3a67e368 0a4d3d50 cf8d5 f476 8201 e328 cbbba50 c741 ebd4f6 b2e1 0316e d218 e1d2 918 0d4204 90efb3ab05fb73 c76 f04 f402 4609 30bbbd8c70 8725 e74dc8 cf9a 5b23 c6 ce52 6d 5a2ffad28c03f5ddc8 b5b1 9f6 5a9a4 f8ff22e 5e28b515a6 e2baff25 e0185 e7457 d94 b3 6e74e1a5 eb8e 6a6629 e94dc3 b8533 4599 8a334 c325 5d17 f25 1a9f0fc09d15d4 76fc381 14dd4 024 c2f27f32d2 1896e 863 d2798 93b4 5fb87d4d3 b709a d32bf1 f855 3822 14eb1 0a 4a2b893 e6f264e6 3adfe30c144aa d9ad6 d154a 23f6b2 be48 d55b74c3677 f31a2 6752 77 33a8d66 6e7d7dc9e13 dd1 05b1 1d31 bb1a 3455 1df2b0 cb9 7186 bc6 d16a 369ee5 b ee72a4a6 c95e 8b44 261 c11b4da31 9ff705 b88da 47d8 4df733 b53a c07db5dfacc 1510e98 0f4 50b60aa5d5a6890 d04 084e1 69f91b0a 0746aa f8db6ad4b36 3cb2aa f7241 c66a 32f777 f8d7 cb0bb287 f89ee b3cc87 25aa013 8eb5 ef5 3e30 c2eaa3 b4 e02a5a6fa 70b0 7f7 fcd90 ba65b61b8 f12 3f1 9667 d8f652fe56 cf4 b7e8a dcc6c3 27fc8c5 9ff18a6 cc5 b550e f27 2207e 2890 e7004 6d87 71b5cc78 c4cc78 b7b5 3ed 7c671 77c6ed c0d9 cb4e3df6 d9b4 f27 9f2 4b01 e9147a 384db32 2798e 50c0f8e b6 be2c8 01b1fb0070 8e12 c6de 961 c5f1c0 06855 d27 b368 f5d3200 457bf86 82875 7da9aa76 fc2 ed63 f83 0eaf0 c38 74ebfb6 7e9c8ed f16 f6dc82 6b51 078e7 60f49c 65a914d4973 444e2 d79a7 58d43b2e 6adbb6da 6d7 cb1 d692 8950 8de5 27b9 8e614 08e5183 8cb468 07e5 f69d5b5 f32e 0b59 dd6 d94 9422a0 b5 cc7e 452e d3c3d3a4 8f c8c0 747 d2d9 988b26a4d181 f8d1ae03e7 8f6a 3d5a4 0036 f14 74f03bfa68a33 1f 24180d1943 19c5b53 60e51 00c27f5c0 6601 be5b55b9 1eb2 908e5 cb1a159e 6e2b bd19 f0b1a72 c4971 21fb1e8 ee703 c88 1d05 b4f370 b27a4 cb9a 76d3 8fc7fa3 9f9 6e4c1 25a430 5bfc91 dc8 7d41 6036 0fb00fca063 6038aae 4774 0cfd0a7 b33ab4d c075 cc2 f31a 7f7 245 c7a5fca8 f749 3b20 d1be27aa69 d40 c7a2 f7f36b3f0ae f35 e190ac1c9 6f6 f10 748 f84c4d3a 7aaad61 9ff8ef2 9806 c05 43c99b8a 20c9a1df4 b83b8 d125 48d1f8 da85e1 7f2 45c47e48 f5 cf18c4a38b4fb6219a 69980 133a2 49 TRANG WEB 82 Bộ Y tế - Cục quản lý khám chữa bệnh (2020), Hợp tác phòng, chống kháng kháng sinh Việt Nam 2021 – 2023, truy cập ngày 18/06/2022, trang web https://kcb.vn/tin-tuc/hop-tac-phong-chong-khang-khang-sinh-tai-viet-nam2021-2023.html 83 CDC (2018), Vietnam Tracks Multi-drug Resistant Bacteria, truy cập ngày 18/06/2022, trang web https://www.cdc.gov/globalhealth/security/stories/vietnam-tracks-multi-drug-resistant-bacteria.html 84 Drugs.com (2022), Drug Interactions Checker, truy cập ngày 09/07/2022, trang web https://www.drugs.com/drug_interactions.html 85 Medscape (2022), Drug Interaction Checker, truy cập ngày 09/07/2022, trang web https://reference.medscape.com/drug-interactionchecker 6f87e 1b11a 932da b860 f81 b6 f9bdc3 2eca c777 6e0cf7 b60da 52f6cf66 b5ff294 1e747 e e1b11a9 32da b860 f81 b6f9bdc32 ecac7776 e0cf7b60da5 2f6 cf66b5ff2941e 747e 6f8 932dab860 f81b6f9 bdc32e cac7776e 0cf7b6 0da5 2f6 cf66b5ff2 941e 747e6 f87e 1b1 1a 860f8 1b6 f9bdc32eca c77 76e0 cf7 b60 da52 f6cf66 b5ff29 41e74 7e6f87e1 b11a9 32da b f81b6f9 bdc32e cac7 776e0 cf7b6 0da52 f6 cf6 6b5ff2 941e7 47e6 f87e 1b11a 932da b86 6f9bdc3 2eca c77 76e0 cf7 b60 da52 f6cf66 b5ff294 1e74 7e6f87e1 b11a9 32dab860 f81 b dc32e cac7776 e0cf7b60da5 2f6 cf66b5ff2941e 747e 6f87 e1b1 1a932 dab8 60f81b6 f9 b 32eca c7776 e0cf7 b60da 52f6cf66b5ff2941 e747e 6f8 7e1b11a932 dab8 60f81b6 f9 bdc c7776 e0cf7b60da 52f6 cf66b5ff2941 e747e 6f8 7e1b11a932 dab8 60f81b6 f9 bdc32e ca e0cf7b60 da52 f6 cf6 6b5ff2 941e7 47e6 f87e 1b11a 932da b860 f81 b6 f9bdc3 2eca c777 fc3a3 f93a 08582 6d66a 60f835 d2406 ea15 f7e7 b88cbf5e9cb78 cc9e16 d1072 e24 c3ee4 7d0800 c6a8 0136 f54 da448 1c2 b397 7f6 f33 e0be 8a4b3 d678 cc5b77 828 cc3 7ae38 f66a4 9c84a7 1dc1cb825a 4f1 d7c732fb9a4 e5765 f83 10c1984 f96 1e06 cf3 fc71f185b5ad74 b fac7b7b2 0dfcfdcdf1 cf4 2b2 fc6 b5a c1e9 c4a51ae fef5b7 de7f4b3 cc9e5d780d33d5 94 9e3f2 1bf4656 147e4 1c5 63d1 76a97 9e946 6be8 9c63 c0e 2907 0df0e654 8e28 c32 c6 f8f7 7ea8e433 c9 f051 8c9 06b9a 684d9d02 5cb598 854db148 3a8024 9bc348 7e1be 4646 2d7a b f21d145b5b08 b8e1 f8 c76 f42 b4ce 759fb93 c48 e7f8a41e7 8571e 64a2 f48b0e5 c8d4 bb8 df3 fa34df8 f2c9de ba5dcb1e e30bc7d67cb1d4163 72d9 47cdab0 1c5 76b2 b2efb3 c49a2 08d258 539 bc6 96d5a 3b1a4 c49 7180 bae30 dc4 4793a3 dc5d19 4ad09 3cb5c3f9 9f2 02398 30ff2d29 b07 f39 d69e d7d2 e358bfca d25b40c5434 0e68a b4ee2 b76e0 b2a8 65300 be6e 95f4 fcb5fd1f4 934 f29e7 ee6d7cfa 31ddc0 5b49 f94 3c1 e22 f3b5 c0e4a d46 2e7c96fc5b 3f9 f11 c9f0 8a6db91a1 7118e 3de6 3e7a02 f9 c1d19137 7d0a7a 34d40ff5b8 453 f6f4e0e 59e15a9 f853 8397 40b3 e9ac33e6fc51 7d8 b739 3a5076 c67 d16e 7cc03df1 b1f0b9 fc0 46 3a67e368 0a4d3d50 cf8d5 f476 8201 e328 cbbba50 c741 ebd4f6 b2e1 0316e d218 e1d2 918 0d4204 90efb3ab05fb73 c76 f04 f402 4609 30bbbd8c70 8725 e74dc8 cf9a 5b23 c6 ce52 6d 5a2ffad28c03f5ddc8 b5b1 9f6 5a9a4 f8ff22e 5e28b515a6 e2baff25 e0185 e7457 d94 b3 6e74e1a5 eb8e 6a6629 e94dc3 b8533 4599 8a334 c325 5d17 f25 1a9f0fc09d15d4 76fc381 14dd4 024 c2f27f32d2 1896e 863 d2798 93b4 5fb87d4d3 b709a d32bf1 f855 3822 14eb1 0a 4a2b893 e6f264e6 3adfe30c144aa d9ad6 d154a 23f6b2 be48 d55b74c3677 f31a2 6752 77 33a8d66 6e7d7dc9e13 dd1 05b1 1d31 bb1a 3455 1df2b0 cb9 7186 bc6 d16a 369ee5 b ee72a4a6 c95e 8b44 261 c11b4da31 9ff705 b88da 47d8 4df733 b53a c07db5dfacc 1510e98 0f4 50b60aa5d5a6890 d04 084e1 69f91b0a 0746aa f8db6ad4b36 3cb2aa f7241 c66a 32f777 f8d7 cb0bb287 f89ee b3cc87 25aa013 8eb5 ef5 3e30 c2eaa3 b4 e02a5a6fa 70b0 7f7 fcd90 ba65b61b8 f12 3f1 9667 d8f652fe56 cf4 b7e8a dcc6c3 27fc8c5 9ff18a6 cc5 b550e f27 2207e 2890 e7004 6d87 71b5cc78 c4cc78 b7b5 3ed 7c671 77c6ed c0d9 cb4e3df6 d9b4 f27 9f2 4b01 e9147a 384db32 2798e 50c0f8e b6 be2c8 01b1fb0070 8e12 c6de 961 c5f1c0 06855 d27 b368 f5d3200 457bf86 82875 7da9aa76 fc2 ed63 f83 0eaf0 c38 74ebfb6 7e9c8ed f16 f6dc82 6b51 078e7 60f49c 65a914d4973 444e2 d79a7 58d43b2e 6adbb6da 6d7 cb1 d692 8950 8de5 27b9 8e614 08e5183 8cb468 07e5 f69d5b5 f32e 0b59 dd6 d94 9422a0 b5 cc7e 452e d3c3d3a4 8f c8c0 747 d2d9 988b26a4d181 f8d1ae03e7 8f6a 3d5a4 0036 f14 74f03bfa68a33 1f 24180d1943 19c5b53 60e51 00c27f5c0 6601 be5b55b9 1eb2 908e5 cb1a159e 6e2b bd19 f0b1a72 c4971 21fb1e8 ee703 c88 1d05 b4f370 b27a4 cb9a 76d3 8fc7fa3 9f9 6e4c1 25a430 5bfc91 dc8 7d41 6036 0fb00fca063 6038aae 4774 0cfd0a7 b33ab4d c075 cc2 f31a 7f7 245 c7a5fca8 f749 3b20 d1be27aa69 d40 c7a2 f7f36b3f0ae f35 e190ac1c9 6f6 f10 748 f84c4d3a 7aaad61 9ff8ef2 9806 c05 43c99b8a 20c9a1df4 b83b8 d125 48d1f8 da85e1 7f2 45c47e48 f5 cf18c4a38b4fb6219a 69980 133a2 49 PHỤ LỤC PHIẾU KHẢO SÁT TOA THUỐC NGOẠI TRÚ THU THẬP THÔNG TIN VỀ BỆNH NHÂN 1.1 THÔNG TIN CHUNG Họ tên bệnh nhân: Giới tính: o Nam o Nữ Mã bệnh nhân: .Tuổi: Ngày khám: Địa chỉ: 1.2 CHẨN ĐỐN 1.2.1 Chẩn đốn bệnh nhiễm khuẩn hơ hấp o Cảm thường o Viêm họng cấp o Viêm amidan cấp o Viêm tai cấp o Viêm xoang cấp o Chẩn đoán khác: 1.2.2 Chẩn đoán bệnh kèm theo o Bệnh đường tiêu hoá o Bệnh nội tiết o Bệnh tim mạch o Bệnh hệ thần kinh o Bệnh xương khớp o Chẩn đoán khác: 6f87e 1b11a 932da b860 f81 b6 f9bdc3 2eca c777 6e0cf7 b60da 52f6cf66 b5ff294 1e747 e e1b11a9 32da b860 f81 b6f9bdc32 ecac7776 e0cf7b60da5 2f6 cf66b5ff2941e 747e 6f8 932dab860 f81b6f9 bdc32e cac7776e 0cf7b6 0da5 2f6 cf66b5ff2 941e 747e6 f87e 1b1 1a 1.3 CHỈ ĐỊNH 860f8 1b6 f9bdc32eca c77 76e0 cf7 b60 da52 f6cf66 b5ff29 41e74 7e6f87e1 b11a9 32da b f81b6f9 bdc32e cac7 776e0 cf7b6 0da52 f6 cf6 6b5ff2 941e7 47e6 f87e 1b11a 932da b86 1.3.1 Thuốc kháng sinh 6f9bdc3 2eca c77 76e0 cf7 b60 da52 f6cf66 b5ff294 1e74 7e6f87e1 b11a9 32dab860 f81 b dc32e cac7776 e0cf7b60da5 2f6 cf66b5ff2941e 747e 6f87 e1b1 1a932 dab8 60f81b6 f9 b 32eca c7776 e0cf7 b60da 52f6cf66b5ff2941 e747e 6f8 7e1b11a932 dab8 60f81b6 f9 bdc STT Tên thuốc Đường dùng Liều dùng Nhịp đưa thuốc Thời gian c7776 e0cf7b60da 52f6 cf66b5ff2941 e747e 6f8 7e1b11a932 dab8 60f81b6 f9 bdc32e ca e0cf7b60 da52 f6 cf6 6b5ff2 941e7 47e6 f87e 1b11a 932da b860 f81 b6 f9bdc3 2eca c777 fc3a3 f93a 08582 6d66a 60f835 d2406 ea15 f7e7 b88cbf5e9cb78 cc9e16 d1072 e24 c3ee4 7d0800 c6a8 0136 f54 da448 1c2 b397 7f6 f33 e0be 8a4b3 d678 cc5b77 828 cc3 7ae38 f66a4 9c84a7 1dc1cb825a 4f1 d7c732fb9a4 e5765 f83 10c1984 f96 1e06 cf3 fc71f185b5ad74 b fac7b7b2 0dfcfdcdf1 cf4 2b2 fc6 b5a c1e9 c4a51ae fef5b7 de7f4b3 cc9e5d780d33d5 94 9e3f2 1bf4656 147e4 1c5 63d1 76a97 9e946 6be8 9c63 c0e 2907 0df0e654 8e28 c32 c6 f8f7 7ea8e433 c9 f051 8c9 06b9a 684d9d02 5cb598 854db148 3a8024 9bc348 7e1be 4646 2d7a b f21d145b5b08 b8e1 f8 c76 f42 b4ce 759fb93 c48 e7f8a41e7 8571e 64a2 f48b0e5 c8d4 bb8 df3 fa34df8 f2c9de ba5dcb1e e30bc7d67cb1d4163 72d9 47cdab0 1c5 76b2 b2efb3 c49a2 08d258 539 bc6 96d5a 3b1a4 c49 7180 bae30 dc4 4793a3 dc5d19 4ad09 3cb5c3f9 9f2 02398 30ff2d29 b07 f39 d69e d7d2 e358bfca d25b40c5434 0e68a b4ee2 b76e0 b2a8 65300 be6e 1.3.2 Thuốc khác 95f4 fcb5fd1f4 934 f29e7 ee6d7cfa 31ddc0 5b49 f94 3c1 e22 f3b5 c0e4a d46 2e7c96fc5b 3f9 f11 c9f0 8a6db91a1 7118e 3de6 3e7a02 f9 c1d19137 7d0a7a 34d40ff5b8 453 f6f4e0e o Thuốc giảm đau hạ sốt o Thuốc kháng viêm corticoid 59e15a9 f853 8397 40b3 e9ac33e6fc51 7d8 b739 3a5076 c67 d16e 7cc03df1 b1f0b9 fc0 46 3a67e368 0a4d3d50 cf8d5 f476 8201 e328 cbbba50 c741 ebd4f6 b2e1 0316e d218 e1d2 918 0d4204 90efb3ab05fb73 c76 f04 f402 4609 30bbbd8c70 8725 e74dc8 cf9a 5b23 c6 ce52 6d o Thuốc ho, long đờm o Vitamin khoáng chất 5a2ffad28c03f5ddc8 b5b1 9f6 5a9a4 f8ff22e 5e28b515a6 e2baff25 e0185 e7457 d94 b3 6e74e1a5 eb8e 6a6629 e94dc3 b8533 4599 8a334 c325 5d17 f25 1a9f0fc09d15d4 76fc381 o Thuốc kháng H1 o Thuốc khác: 14dd4 024 c2f27f32d2 1896e 863 d2798 93b4 5fb87d4d3 b709a d32bf1 f855 3822 14eb1 0a 4a2b893 e6f264e6 3adfe30c144aa d9ad6 d154a 23f6b2 be48 d55b74c3677 f31a2 6752 77 33a8d66 6e7d7dc9e13 dd1 05b1 1d31 bb1a 3455 1df2b0 cb9 7186 bc6 d16a 369ee5 b ee72a4a6 c95e 8b44 261 c11b4da31 9ff705 b88da 47d8 4df733 b53a c07db5dfacc 1510e98 0f4 50b60aa5d5a6890 d04 084e1 69f91b0a 0746aa f8db6ad4b36 3cb2aa f7241 c66a 32f777 f8d7 cb0bb287 f89ee b3cc87 25aa013 8eb5 ef5 3e30 c2eaa3 b4 e02a5a6fa 70b0 7f7 fcd90 ba65b61b8 f12 3f1 9667 d8f652fe56 cf4 b7e8a dcc6c3 27fc8c5 9ff18a6 cc5 b550e f27 2207e 2890 e7004 6d87 71b5cc78 c4cc78 b7b5 3ed 7c671 77c6ed c0d9 cb4e3df6 d9b4 f27 9f2 4b01 e9147a 384db32 2798e 50c0f8e b6 be2c8 01b1fb0070 8e12 c6de 961 c5f1c0 06855 d27 b368 f5d3200 457bf86 82875 7da9aa76 fc2 ed63 f83 0eaf0 c38 74ebfb6 7e9c8ed f16 f6dc82 6b51 078e7 60f49c 65a914d4973 444e2 d79a7 58d43b2e 6adbb6da 6d7 cb1 d692 8950 8de5 27b9 8e614 08e5183 8cb468 07e5 f69d5b5 f32e 0b59 dd6 d94 9422a0 b5 cc7e 452e d3c3d3a4 8f c8c0 747 d2d9 988b26a4d181 f8d1ae03e7 8f6a 3d5a4 0036 f14 74f03bfa68a33 1f 24180d1943 19c5b53 60e51 00c27f5c0 6601 be5b55b9 1eb2 908e5 cb1a159e 6e2b bd19 f0b1a72 c4971 21fb1e8 ee703 c88 1d05 b4f370 b27a4 cb9a 76d3 8fc7fa3 9f9 6e4c1 25a430 5bfc91 dc8 7d41 6036 0fb00fca063 6038aae 4774 0cfd0a7 b33ab4d c075 cc2 f31a 7f7 245 c7a5fca8 f749 3b20 d1be27aa69 d40 c7a2 f7f36b3f0ae f35 e190ac1c9 6f6 f10 748 f84c4d3a 7aaad61 9ff8ef2 9806 c05 43c99b8a 20c9a1df4 b83b8 d125 48d1f8 da85e1 7f2 45c47e48 f5 cf18c4a38b4fb6219a 69980 133a2 49 KHẢO SÁT TÍNH AN TOÀN – HỢP LÝ CHỈ ĐỊNH KHÁNG SINH 2.1 KHẢO SÁT CHỈ ĐỊNH KHÁNG SINH AN TOÀN – HỢP LÝ Tiêu chí Nhận xét TLTK 2.1.1 Lựa chọn kháng sinh o An tồn – hợp lý o Khơng an tồn – hợp lý 2.1.2 Đường dùng thuốc o An toàn – hợp lý o Khơng an tồn – hợp lý 2.1.3 Phối hợp kháng sinh o An toàn – hợp lý o Khơng an tồn – hợp lý 2.1.4 Liều lượng nhịp đưa thuốc o An toàn – hợp lý o Khơng an tồn – hợp lý 2.1.5 Thời gian sử dụng o An toàn – hợp lý o Khơng an tồn – hợp lý 2.2 KHẢO SÁT TƯƠNG TÁC KHÁNG SINH Tương tác khác sinh 2.2.1 Toa thuốc có xuất cặp tương tác Nhận xét 6f87e 1b11a 932da b860 f81 b6 f9bdc3 2eca c777 6e0cf7 b60da 52f6cf66 b5ff294 1e747 e e1b11a9 32da b860 f81 b6f9bdc32 ecac7776 e0cf7b60da5 2f6 cf66b5ff2941e 747e 6f8 932dab860 f81b6f9 bdc32e cac7776e 0cf7b6 0da5 2f6 cf66b5ff2 941e 747e6 f87e 1b1 1a o Có o Không 860f8 1b6 f9bdc32eca c77 76e0 cf7 b60 da52 f6cf66 b5ff29 41e74 7e6f87e1 b11a9 32da b f81b6f9 bdc32e cac7 776e0 cf7b6 0da52 f6 cf6 6b5ff2 941e7 47e6 f87e 1b11a 932da b86 2.2.2 Mức độ cặp tương tác theo Medscape 6f9bdc3 2eca c77 76e0 cf7 b60 da52 f6cf66 b5ff294 1e74 7e6f87e1 b11a9 32dab860 f81 b dc32e cac7776 e0cf7b60da5 2f6 cf66b5ff2941e 747e 6f87 e1b1 1a932 dab8 60f81b6 f9 b 32eca c7776 e0cf7 b60da 52f6cf66b5ff2941 e747e 6f8 7e1b11a932 dab8 60f81b6 f9 bdc o Chống định c7776 e0cf7b60da 52f6 cf66b5ff2941 e747e 6f8 7e1b11a932 dab8 60f81b6 f9 bdc32e ca e0cf7b60 da52 f6 cf6 6b5ff2 941e7 47e6 f87e 1b11a 932da b860 f81 b6 f9bdc3 2eca c777 o Nghiêm trọng o Theo dõi chặt chẽ fc3a3 f93a 08582 6d66a 60f835 d2406 ea15 f7e7 b88cbf5e9cb78 cc9e16 d1072 e24 c3ee4 7d0800 c6a8 0136 f54 da448 1c2 b397 7f6 f33 e0be 8a4b3 d678 cc5b77 828 cc3 7ae38 f66a4 9c84a7 1dc1cb825a 4f1 d7c732fb9a4 e5765 f83 10c1984 f96 1e06 cf3 fc71f185b5ad74 b fac7b7b2 0dfcfdcdf1 cf4 2b2 fc6 b5a c1e9 c4a51ae fef5b7 de7f4b3 cc9e5d780d33d5 94 9e3f2 1bf4656 147e4 1c5 63d1 76a97 9e946 6be8 9c63 c0e 2907 0df0e654 8e28 c32 c6 f8f7 o Nhẹ 2.2.3 Mức độ cặp tương tác theo Drugs.com 7ea8e433 c9 f051 8c9 06b9a 684d9d02 5cb598 854db148 3a8024 9bc348 7e1be 4646 2d7a b f21d145b5b08 b8e1 f8 c76 f42 b4ce 759fb93 c48 e7f8a41e7 8571e 64a2 f48b0e5 c8d4 bb8 df3 fa34df8 f2c9de ba5dcb1e e30bc7d67cb1d4163 72d9 47cdab0 1c5 76b2 b2efb3 c49a2 08d258 539 bc6 96d5a 3b1a4 c49 7180 bae30 dc4 4793a3 dc5d19 4ad09 3cb5c3f9 9f2 02398 30ff2d29 b07 f39 d69e d7d2 e358bfca d25b40c5434 0e68a b4ee2 b76e0 b2a8 65300 be6e o Nguy hiểm 95f4 fcb5fd1f4 934 f29e7 ee6d7cfa 31ddc0 5b49 f94 3c1 e22 f3b5 c0e4a d46 2e7c96fc5b 3f9 f11 c9f0 8a6db91a1 7118e 3de6 3e7a02 f9 c1d19137 7d0a7a 34d40ff5b8 453 f6f4e0e o Trung bình 59e15a9 f853 8397 40b3 e9ac33e6fc51 7d8 b739 3a5076 c67 d16e 7cc03df1 b1f0b9 fc0 46 3a67e368 0a4d3d50 cf8d5 f476 8201 e328 cbbba50 c741 ebd4f6 b2e1 0316e d218 e1d2 918 0d4204 90efb3ab05fb73 c76 f04 f402 4609 30bbbd8c70 8725 e74dc8 cf9a 5b23 c6 ce52 6d o Thấp 5a2ffad28c03f5ddc8 b5b1 9f6 5a9a4 f8ff22e 5e28b515a6 e2baff25 e0185 e7457 d94 b3 6e74e1a5 eb8e 6a6629 e94dc3 b8533 4599 8a334 c325 5d17 f25 1a9f0fc09d15d4 76fc381 14dd4 024 c2f27f32d2 1896e 863 d2798 93b4 5fb87d4d3 b709a d32bf1 f855 3822 14eb1 0a 4a2b893 e6f264e6 3adfe30c144aa d9ad6 d154a 23f6b2 be48 d55b74c3677 f31a2 6752 77 33a8d66 6e7d7dc9e13 dd1 05b1 1d31 bb1a 3455 1df2b0 cb9 7186 bc6 d16a 369ee5 b ee72a4a6 c95e 8b44 261 c11b4da31 9ff705 b88da 47d8 4df733 b53a c07db5dfacc 1510e98 0f4 50b60aa5d5a6890 d04 084e1 69f91b0a 0746aa f8db6ad4b36 3cb2aa f7241 c66a 32f777 f8d7 cb0bb287 f89ee b3cc87 25aa013 8eb5 ef5 3e30 c2eaa3 b4 e02a5a6fa 70b0 7f7 fcd90 ba65b61b8 f12 3f1 9667 d8f652fe56 cf4 b7e8a dcc6c3 27fc8c5 9ff18a6 cc5 b550e f27 2207e 2890 e7004 6d87 71b5cc78 c4cc78 b7b5 3ed 7c671 77c6ed c0d9 cb4e3df6 d9b4 f27 9f2 4b01 e9147a 384db32 2798e 50c0f8e b6 be2c8 01b1fb0070 8e12 c6de 961 c5f1c0 06855 d27 b368 f5d3200 457bf86 82875 7da9aa76 fc2 ed63 f83 0eaf0 c38 74ebfb6 7e9c8ed f16 f6dc82 6b51 078e7 60f49c 65a914d4973 444e2 d79a7 58d43b2e 6adbb6da 6d7 cb1 d692 8950 8de5 27b9 8e614 08e5183 8cb468 07e5 f69d5b5 f32e 0b59 dd6 d94 9422a0 b5 cc7e 452e d3c3d3a4 8f c8c0 747 d2d9 988b26a4d181 f8d1ae03e7 8f6a 3d5a4 0036 f14 74f03bfa68a33 1f 24180d1943 19c5b53 60e51 00c27f5c0 6601 be5b55b9 1eb2 908e5 cb1a159e 6e2b bd19 f0b1a72 c4971 21fb1e8 ee703 c88 1d05 b4f370 b27a4 cb9a 76d3 8fc7fa3 9f9 6e4c1 25a430 5bfc91 dc8 7d41 6036 0fb00fca063 6038aae 4774 0cfd0a7 b33ab4d c075 cc2 f31a 7f7 245 c7a5fca8 f749 3b20 d1be27aa69 d40 c7a2 f7f36b3f0ae f35 e190ac1c9 6f6 f10 748 f84c4d3a 7aaad61 9ff8ef2 9806 c05 43c99b8a 20c9a1df4 b83b8 d125 48d1f8 da85e1 7f2 45c47e48 f5 cf18c4a38b4fb6219a 69980 133a2 49 6f87e 1b11a 932da b860 f81 b6 f9bdc3 2eca c777 6e0cf7 b60da 52f6cf66 b5ff294 1e747 e e1b11a9 32da b860 f81 b6f9bdc32 ecac7776 e0cf7b60da5 2f6 cf66b5ff2941e 747e 6f8 932dab860 f81b6f9 bdc32e cac7776e 0cf7b6 0da5 2f6 cf66b5ff2 941e 747e6 f87e 1b1 1a 860f8 1b6 f9bdc32eca c77 76e0 cf7 b60 da52 f6cf66 b5ff29 41e74 7e6f87e1 b11a9 32da b f81b6f9 bdc32e cac7 776e0 cf7b6 0da52 f6 cf6 6b5ff2 941e7 47e6 f87e 1b11a 932da b86 6f9bdc3 2eca c77 76e0 cf7 b60 da52 f6cf66 b5ff294 1e74 7e6f87e1 b11a9 32dab860 f81 b dc32e cac7776 e0cf7b60da5 2f6 cf66b5ff2941e 747e 6f87 e1b1 1a932 dab8 60f81b6 f9 b 32eca c7776 e0cf7 b60da 52f6cf66b5ff2941 e747e 6f8 7e1b11a932 dab8 60f81b6 f9 bdc c7776 e0cf7b60da 52f6 cf66b5ff2941 e747e 6f8 7e1b11a932 dab8 60f81b6 f9 bdc32e ca e0cf7b60 da52 f6 cf6 6b5ff2 941e7 47e6 f87e 1b11a 932da b860 f81 b6 f9bdc3 2eca c777 fc3a3 f93a 08582 6d66a 60f835 d2406 ea15 f7e7 b88cbf5e9cb78 cc9e16 d1072 e24 c3ee4 7d0800 c6a8 0136 f54 da448 1c2 b397 7f6 f33 e0be 8a4b3 d678 cc5b77 828 cc3 7ae38 f66a4 9c84a7 1dc1cb825a 4f1 d7c732fb9a4 e5765 f83 10c1984 f96 1e06 cf3 fc71f185b5ad74 b fac7b7b2 0dfcfdcdf1 cf4 2b2 fc6 b5a c1e9 c4a51ae fef5b7 de7f4b3 cc9e5d780d33d5 94 9e3f2 1bf4656 147e4 1c5 63d1 76a97 9e946 6be8 9c63 c0e 2907 0df0e654 8e28 c32 c6 f8f7 7ea8e433 c9 f051 8c9 06b9a 684d9d02 5cb598 854db148 3a8024 9bc348 7e1be 4646 2d7a b f21d145b5b08 b8e1 f8 c76 f42 b4ce 759fb93 c48 e7f8a41e7 8571e 64a2 f48b0e5 c8d4 bb8 df3 fa34df8 f2c9de ba5dcb1e e30bc7d67cb1d4163 72d9 47cdab0 1c5 76b2 b2efb3 c49a2 08d258 539 bc6 96d5a 3b1a4 c49 7180 bae30 dc4 4793a3 dc5d19 4ad09 3cb5c3f9 9f2 02398 30ff2d29 b07 f39 d69e d7d2 e358bfca d25b40c5434 0e68a b4ee2 b76e0 b2a8 65300 be6e 95f4 fcb5fd1f4 934 f29e7 ee6d7cfa 31ddc0 5b49 f94 3c1 e22 f3b5 c0e4a d46 2e7c96fc5b 3f9 f11 c9f0 8a6db91a1 7118e 3de6 3e7a02 f9 c1d19137 7d0a7a 34d40ff5b8 453 f6f4e0e 59e15a9 f853 8397 40b3 e9ac33e6fc51 7d8 b739 3a5076 c67 d16e 7cc03df1 b1f0b9 fc0 46 3a67e368 0a4d3d50 cf8d5 f476 8201 e328 cbbba50 c741 ebd4f6 b2e1 0316e d218 e1d2 918 0d4204 90efb3ab05fb73 c76 f04 f402 4609 30bbbd8c70 8725 e74dc8 cf9a 5b23 c6 ce52 6d 5a2ffad28c03f5ddc8 b5b1 9f6 5a9a4 f8ff22e 5e28b515a6 e2baff25 e0185 e7457 d94 b3 6e74e1a5 eb8e 6a6629 e94dc3 b8533 4599 8a334 c325 5d17 f25 1a9f0fc09d15d4 76fc381 14dd4 024 c2f27f32d2 1896e 863 d2798 93b4 5fb87d4d3 b709a d32bf1 f855 3822 14eb1 0a 4a2b893 e6f264e6 3adfe30c144aa d9ad6 d154a 23f6b2 be48 d55b74c3677 f31a2 6752 77 33a8d66 6e7d7dc9e13 dd1 05b1 1d31 bb1a 3455 1df2b0 cb9 7186 bc6 d16a 369ee5 b ee72a4a6 c95e 8b44 261 c11b4da31 9ff705 b88da 47d8 4df733 b53a c07db5dfacc 1510e98 0f4 50b60aa5d5a6890 d04 084e1 69f91b0a 0746aa f8db6ad4b36 3cb2aa f7241 c66a 32f777 f8d7 cb0bb287 f89ee b3cc87 25aa013 8eb5 ef5 3e30 c2eaa3 b4 e02a5a6fa 70b0 7f7 fcd90 ba65b61b8 f12 3f1 9667 d8f652fe56 cf4 b7e8a dcc6c3 27fc8c5 9ff18a6 cc5 b550e f27 2207e 2890 e7004 6d87 71b5cc78 c4cc78 b7b5 3ed 7c671 77c6ed c0d9 cb4e3df6 d9b4 f27 9f2 4b01 e9147a 384db32 2798e 50c0f8e b6 be2c8 01b1fb0070 8e12 c6de 961 c5f1c0 06855 d27 b368 f5d3200 457bf86 82875 7da9aa76 fc2 ed63 f83 0eaf0 c38 74ebfb6 7e9c8ed f16 f6dc82 6b51 078e7 60f49c 65a914d4973 444e2 d79a7 58d43b2e 6adbb6da 6d7 cb1 d692 8950 8de5 27b9 8e614 08e5183 8cb468 07e5 f69d5b5 f32e 0b59 dd6 d94 9422a0 b5 cc7e 452e d3c3d3a4 8f c8c0 747 d2d9 988b26a4d181 f8d1ae03e7 8f6a 3d5a4 0036 f14 74f03bfa68a33 1f 24180d1943 19c5b53 60e51 00c27f5c0 6601 be5b55b9 1eb2 908e5 cb1a159e 6e2b bd19 f0b1a72 c4971 21fb1e8 ee703 c88 1d05 b4f370 b27a4 cb9a 76d3 8fc7fa3 9f9 6e4c1 25a430 5bfc91 dc8 7d41 6036 0fb00fca063 6038aae 4774 0cfd0a7 b33ab4d c075 cc2 f31a 7f7 245 c7a5fca8 f749 3b20 d1be27aa69 d40 c7a2 f7f36b3f0ae f35 e190ac1c9 6f6 f10 748 f84c4d3a 7aaad61 9ff8ef2 9806 c05 43c99b8a 20c9a1df4 b83b8 d125 48d1f8 da85e1 7f2 45c47e48 f5 cf18c4a38b4fb6219a 69980 133a2 49 6f87e 1b11a 932da b860 f81 b6 f9bdc3 2eca c777 6e0cf7 b60da 52f6cf66 b5ff294 1e747 e e1b11a9 32da b860 f81 b6f9bdc32 ecac7776 e0cf7b60da5 2f6 cf66b5ff2941e 747e 6f8 932dab860 f81b6f9 bdc32e cac7776e 0cf7b6 0da5 2f6 cf66b5ff2 941e 747e6 f87e 1b1 1a 860f8 1b6 f9bdc32eca c77 76e0 cf7 b60 da52 f6cf66 b5ff29 41e74 7e6f87e1 b11a9 32da b f81b6f9 bdc32e cac7 776e0 cf7b6 0da52 f6 cf6 6b5ff2 941e7 47e6 f87e 1b11a 932da b86 6f9bdc3 2eca c77 76e0 cf7 b60 da52 f6cf66 b5ff294 1e74 7e6f87e1 b11a9 32dab860 f81 b dc32e cac7776 e0cf7b60da5 2f6 cf66b5ff2941e 747e 6f87 e1b1 1a932 dab8 60f81b6 f9 b 32eca c7776 e0cf7 b60da 52f6cf66b5ff2941 e747e 6f8 7e1b11a932 dab8 60f81b6 f9 bdc c7776 e0cf7b60da 52f6 cf66b5ff2941 e747e 6f8 7e1b11a932 dab8 60f81b6 f9 bdc32e ca e0cf7b60 da52 f6 cf6 6b5ff2 941e7 47e6 f87e 1b11a 932da b860 f81 b6 f9bdc3 2eca c777 fc3a3 f93a 08582 6d66a 60f835 d2406 ea15 f7e7 b88cbf5e9cb78 cc9e16 d1072 e24 c3ee4 7d0800 c6a8 0136 f54 da448 1c2 b397 7f6 f33 e0be 8a4b3 d678 cc5b77 828 cc3 7ae38 f66a4 9c84a7 1dc1cb825a 4f1 d7c732fb9a4 e5765 f83 10c1984 f96 1e06 cf3 fc71f185b5ad74 b fac7b7b2 0dfcfdcdf1 cf4 2b2 fc6 b5a c1e9 c4a51ae fef5b7 de7f4b3 cc9e5d780d33d5 94 9e3f2 1bf4656 147e4 1c5 63d1 76a97 9e946 6be8 9c63 c0e 2907 0df0e654 8e28 c32 c6 f8f7 7ea8e433 c9 f051 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