ĐẶC ĐIỂM SỬ DỤNG KHÁNG SINH KINH NGHIỆM VÀ TỶ LỆ ĐỀ KHÁNG KHÁNG SINH TẠI KHOA HỒI SỨC TÍCH CỰC - CHỐNG ĐỘC BỆNH VIỆN ĐA KHOA TRÀ VINH NĂM 2024

Abstract

Background: The utilization of empirical antibiotic plays a crucial role in the emergence and progression of antimicrobial resistance, which in turn affects treatment efficacy, costs, and mortality rates. Objectives: To investigate the characteristics of empirical antibiotic use and the antibiotic resistance rates of isolated bacterial strains. Materials and methods: A cross-sectional descriptive study was conducted on 200 medical records from patients who received antibiotics and had culture and susceptibility (C & S) reports at the Intensive Care and Toxicology Department of Tra Vinh General Hospital from March to November, 2024. Results: The most frequently used empirical antibiotic group was beta-lactams (50%), with carbapenems accounting for 33%. This was followed by fluoroquinolon (42.3%) and glycopeptides (13.3%), while other antibiotic groups accounted for less than 3%. Dual antibiotic therapy was the most common regimen (79%). Among the 200 medical records reviewed, 148 had positive C & S results. The distribution of cultured samples was as follows: 55.5% from sputum, 26% from blood, 13% from pus, and 5.5% from other body fluids. The most frequently isolated bacterial strain was Klebsiella pneumoniae (31.2%), followed by Acinetobacter baumannii (15.5%). The antibiotic resistance rates for Klebsiella pneumoniae were 56.5% to carbapenems, 65%-97% to penicillins, 70%-87% to cephalosporins, and over 90% to fluoroquinolon. Acinetobacter baumannii exhibited resistance exceeding 90% to nearly all tested antibiotics. Conclusion: The research results showed that the resistance rates of the isolated microorganisms were high, with resistance to imipenem and levofloxacin exceeding 50% and 90%, respectively. However, the use of these two antibiotics in empirical treatment remained relatively high. Therefore, it is necessary to implement strategies for managing, monitoring, and optimizing the use of empirical antibiotics to improve treatment effectiveness.