title: Antibiotic therapy for inpatients with community-acquired pneumonia in a developing country.
abstract: OBJECTIVE
  The aim of this study was to identify antibiotic prescription patterns for community-acquired pneumonia (CAP) in Vietnam.
  
  
  METHODS
  Medical records for CAP adult patients admitted to 10 hospitals across the country were randomly selected from admission lists during the peak pneumonia season. CAP cases were identified from manual record reviews by clinical pharmacists. Data was collected using a standard data collection tool including patient clinical features on admission, comorbidities, microbiological culture results, and antibiotic regimens. Pneumonia severity was estimated using the CURB-65 score.
  
  
  RESULTS
  A total of 649 medical records for adult patients (55.2% male and 52.3% urban residents, median age 68 years) met the selection criteria for CAP. Pneumonia severity was assessed as mild (64.1% of patients), moderate (23.0%), and severe (9.2%). Antibiotics were most frequently administered intravenously (93.4%) and as combination therapy (dual therapy 54.4%, monotherapy 42.5%, and triple therapy 3.1% of patients) regardless of CAP severity. Third-generation cephalosporins were used most frequently (29.3% as monotherapy and 40.4% as combination therapy). Third-generation cephalosporins were most commonly combined with penicillins and/or quinolones.
  
  
  CONCLUSIONS
  This first nationwide study provides a baseline profile of antibiotic use in the treatment of CAP. Third-generation cephalosporins were widely used for initial empirical management of CAP, often in combination with quinolones, regardless of CAP severity. The study will assist in providing an evidence base to inform new national antibiotic guidelines for CAP management and will contribute locally relevant data for the national master plan addressing antibiotic resistance and the development of educational interventions to improve CAP management.
authors.affiliation: Department of Clinical Pharmacy, Hanoi University of Pharmacy, Hanoi, Vietnam.
authors.forename: Hieu T
authors.initials: HT
authors.lastname: Trinh
authors.forename: Phuong H
authors.initials: PH
authors.lastname: Hoang
authors.forename: Magnolia
authors.initials: M
authors.lastname: Cardona-Morrell
authors.forename: Hai T
authors.initials: HT
authors.lastname: Nguyen
authors.forename: Dinh Hoa
authors.initials: DH
authors.lastname: Vu
authors.forename: Phuong T X
authors.initials: PT
authors.lastname: Dong
authors.forename: Thao T B
authors.initials: TT
authors.lastname: Cao
authors.forename: Son T
authors.initials: ST
authors.lastname: Nguyen
authors.forename: Van T T
authors.initials: VT
authors.lastname: Pham
authors.forename: Le
authors.initials: L
authors.lastname: Moss
authors.forename: Kathryn
authors.initials: K
authors.lastname: Dinh
authors.forename: Jonathan
authors.initials: J
authors.lastname: Dartnell
authors.forename: Huong T L
authors.initials: HT
authors.lastname: Nguyen
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D017714:Community-Acquired Infections / Q000188:drug therapy*; D003906:Developing Countries; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018410:Pneumonia, Bacterial / Q000188:drug therapy*; D012189:Retrospective Studies; D014744:Vietnam / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents
keywords: Vietnam; antibiotics; community-acquired pneumonia (CAP); developing country; drug utilization evaluation; pharmacoepidemiology