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Antibiotic use in children hospitalised with pneumonia in Central Vietnam
  1. Phuong TK Nguyen1,2,
  2. Hoang T Tran3,
  3. Dominic A Fitzgerald2,4,
  4. Steve M Graham5,6,
  5. Ben J Marais2
  1. 1Department of Respirology, Da Nang Hospital for Women and Children, Da Nang, Vietnam
  2. 2Discipline of Paediatrics and Adolescent Medicine, The University of Sydney, Sydney, New South Wales, Australia
  3. 3Department of Neonatology, Da Nang Hospital for Women and Children, Da Nang, Vietnam
  4. 4Respiratory Medicine, Children's Hospital at Westmead, Sydney, New South Wales, Australia
  5. 5Department of Paediatrics, Centre for International Child Health, University of Melbourne, Melbourne, Victoria, Australia
  6. 6Murdoch Children’s Research Institute, Royal Children’s Hospital, Melbourne, Australia, Melbourne, Victoria, Australia
  1. Correspondence to Dr Phuong TK Nguyen, Respirology, Da Nang hospital for Women and Children, Da Nang 55000, Viet Nam; thng5150{at}uni.sydney.edu.au

Abstract

Background and objectives Excessive use of antibiotics has been noted in children with respiratory tract infections in Vietnam, but antibiotic use in hospitalised children is poorly documented. Antibiotic use and direct healthcare costs in children hospitalised with pneumonia in central Vietnam were assessed.

Methods A prospective descriptive study of children under 5 years old admitted with a primary admission diagnosis of ‘pneumonia’ to the Da Nang Hospital for Women and Children over 1 year.

Results Of 2911 children hospitalised with pneumonia, 2735 (94.0%) were classified as ‘non-severe’ pneumonia by the admitting physician. In total, 2853 (98.0%) children received antibiotics. Intravenous antibiotics were given to 336 (12.3%) children with ‘non-severe’ and 157/176 (89.2%) children with ‘severe’ pneumonia; those with ‘non-severe’ pneumonia accounted for 68.2% (336/493) of intravenous antibiotics given. Only 19.3% (95/493) of children on intravenous antibiotics were stepped down to an oral antibiotic. Cefuroxime was the preferred oral agent, and ceftriaxone was the preferred injectable agent. Hospital admission for oral antibiotics in ‘non-severe’ pneumonia was a major cost driver, with an average direct cost of US$78.9 per patient, accounting for 54.0% of the total hospitalisation cost in the study cohort. In addition, 336 (12.3%) children with non-severe pneumonia received intravenous antibiotics without indication, accounting for a further 23.2% of hospitalisation costs.

Conclusion Limiting unnecessary hospitalisation and considering early intravenous to oral step down antibiotic will reduce direct health system costs and morbidity in children with respiratory tract infections in Vietnam.

  • antibiotic
  • antimicrobial resistance
  • childhood pneumonia
  • hospital cost
  • treatment guideline
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Footnotes

  • Contributors PTKN, SMG and BJM conceptualised the study and designed the protocol. PTKN collected the data and drafted the manuscript. PTKN and BJM analysed the data. All authors reviewed and approved the final manuscript.

  • Funding PTKN holds a Da Nang government PhD scholarship and work at the Da Nang Hospital for Women and Children.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; internally peer reviewed.

  • Data availability statement Data are available on reasonable request. The first author (PTKN) are holding original data. Please email her at thng5150@uni.sydney.edu.au for data sharing request.

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