40. INVESTIGATION ON ANTIBIOTIC USE IN TREATMENT OF SKIN AND SOFT TISSUE INFECTIONS AT BECAMEX INTERNATIONAL HOSPITALINVESTIGATION ON ANTIBIOTIC USE IN TREATMENT OF SKIN AND SOFT TISSUE INFECTIONS AT BECAMEX INTERNATIONAL HOSPITAL
Main Article Content
Abstract
Objectives: To investigate the pathogens and initial empirical antibiotic use in the treatment of skin and soft tissue infections at Becamex International Hospital.
Materials and methods: A cross-sectional descriptive study was conducted on inpatients with skin and soft tissue infections from May 2022 to December 2022.
Results: The most prevalent pathogen isolated was Staphylococcus aureus (55.6%). The majority of S. aureus strains were Methicillin-resistant (92%). In patients without bacterial culture test, 50.6% received initial empirical antibiotics appropriately according to the guideline. In patients with antibiotic susceptibility testing, only 31% received antibiotics appropriately. Multivariate logistic regression models did not reveal any association between prolonged antibiotic use (> 7 days) and risk factors.
Conclusion: The rate of appropriate initial empirical antibiotic prescription according to both treatment guidelines and susceptibility results remains low. It is necessary to improve initial empirical antibiotic selection, particularly based on microbiological characteristics of local.
Article Details
Keywords
Antibiotic, antibiotic susceptibility testing, skin and soft tissue infections.
References
[2]. Miller L.G, Eisenberg D.F, Liu H, Chang C.L, Wang Y, Luthra R, et al. Incidence of skin and soft tissue infections in ambulatory and inpatient settings, 2005-2010. BMC Infect Dis. 2015; 15: 362.
[3]. Bộ Y tế. Báo cáo giám sát kháng kháng sinh tại Việt Nam 2020. Hà Nội 2023.
[4]. Ki V, Rotstein C. Bacterial skin and soft tissue infections in adults: A review of their epidemiology, pathogenesis, diagnosis, treatment and site of care. Can J Infect Dis Med Microbiol. 2008; 19 (2): 173-84.
[5]. Nguyễn Ngọc Hòa, Nguyễn Thị Mai Thơ. Đặc điểm kháng kháng sinh của các chủng vi khuẩn gây nhiễm khuẩn da và mô mềm phân lập được tại Bệnh viện Hữu nghị đa khoa Nghệ An. Tạp chí Y học Việt Nam. 2022; 515 (2): 285-289.
[6]. Walsh T.L, Chan L, Konopka C.I, Burkitt M.J, Moffa M.A, Bremmer D.N, et al. Appropriateness of antibiotic management of uncomplicated skin and soft tissue infections in hospitalized adult patients. BMC Infect Dis. 2016; 16 (1): 721.
[7]. Nguyễn Thị Huỳnh, Hà Nguyễn Y Khuê, Đặng Nguyễn Đoan Trang. Khảo sát việc sử dụng kháng sinh trong điều trị nhiễm khuẩn da mô mềm tại Bệnh viện Đại học Y Dược Thành phố Hồ Chí Minh. Tạp chí Y Dược lâm sàng 108, 2021, 16 (số đặc biệt): 128-135.
[8]. Moran G.J, Krishnadasan A, Gorwitz R.J, Fosheim G.E, McDougal L.K, Carey R.B, et al. Methicillin-resistant S. aureus infections among patients in the emergency department. N Engl J Med. 2006; 355 (7): 666-74.
[9]. Stevens D.L, Bisno A.L, Chambers H.F, Dellinger E.P, Goldstein E.J, Gorbach S.L, et al. Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the Infectious Diseases Society of America. Clin Infect Dis. 2014; 59 (2): e10-52.
[10]. Sanchez Garcia M, De la Torre M.A, Morales G, Pelaez B, Tolon M.J, Domingo S, et al. Clinical outbreak of linezolid-resistant Staphylococcus aureus in an intensive care unit. JAMA. 2010; 303 (22): 2260-4.
[11]. Choi G.W, Lee J.Y, Chang M.J, Kim Y.K, Cho Y, Yu Y.M, et al. Risk factors for linezolid-induced thrombocytopenia in patients without haemato-oncologic diseases. Basic Clin Pharmacol Toxicol. 2019; 124 (2): 228-34.
[12]. Guidance for industry: acute bacterial skin and skin structure infections: developing drugs for treatment Silver Spring, MD: Food and Drug Administration, Center for Drug Evaluation and Research; [Available from: http://www.fda.gov/downloads/drugs/guidancecomplianceregulatoryinformation/guidances/ucm071185.pdf/.
[13]. Cellulitis and erysipelas: antimicrobial prescribing NICE guideline 2019 [Available from: https://www.nice.org.uk/guidance/ng141.
[14]. Inaoki M, Inaoki A, Nishijima C. Factors that affect the duration of antimicrobial therapy for cellulitis. J Infect Chemother. 2018; 24 (4): 256-61.