Factors influencing choices of empirical antibiotic treatment for bacterial infections in a scenario-based survey in Vietnam
<strong>Background</strong> Antimicrobial stewardship (AMS) programmes have been implemented around the world to guide rational use of antibiotics but implementation is challenging, particularly in low- and middle-income countries, including Vietnam. Understanding factors influencing doc...
| Main Authors: | , , , , , , |
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| Format: | Journal article |
| Language: | English |
| Published: |
Oxford University Press
2020
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| _version_ | 1826285478300614656 |
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| author | Vu, TLH Vu, QD Hoang, BL Nguyen, TCT Ta, TDN Nadjm, B van Doorn, HR |
| author_facet | Vu, TLH Vu, QD Hoang, BL Nguyen, TCT Ta, TDN Nadjm, B van Doorn, HR |
| author_sort | Vu, TLH |
| collection | OXFORD |
| description | <strong>Background</strong>
Antimicrobial stewardship (AMS) programmes have been implemented around the world to guide rational use of antibiotics but implementation is challenging, particularly in low- and middle-income countries, including Vietnam. Understanding factors influencing doctors’ prescribing choices for empirical treatment can help design AMS interventions in these settings.
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<strong>Objectives</strong>
To understand doctors’ choices of antibiotics for empirical treatment of common bacterial infections and the factors influencing decision-making.
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<strong>Methods</strong>
We conducted a cross-sectional survey among medical professionals applying for a postgraduate programme at Hanoi Medical University, Vietnam. We used a published survey developed for internal medicine doctors in Canada. The survey was self-administered and included four clinical scenarios: (i) severe undifferentiated sepsis; (ii) mild undifferentiated sepsis; (iii) severe genitourinary infection; and (iv) mild genitourinary infection.
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<strong>Results</strong>
A total of 1011/1280 (79%), 683/1188 (57.5%), 718/1157 (62.1%) and 542/1062 (51.0%) of the participants selected combination therapy for empirical treatment in scenarios 1, 2, 3 and 4, respectively. Undifferentiated sepsis (OR 1.82, 95% CI 1.46–2.27 and 2.18, 1.51–3.16 compared with genitourinary) and severe infection (1.33, 1.24–1.43 and 1.38, 1.21–1.58 compared with mild) increased the likelihood of choosing a combination therapy and a carbapenem regimen, respectively. Participants with higher acceptable minimum threshold for treatment coverage and young age were also more likely to prescribe carbapenems.
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<strong>Conclusions</strong>
Decision-making in antibiotic prescribing among doctors in Vietnam is influenced by both disease-related characteristics and individual factors, including acceptable minimum treatment coverage. These findings are useful for tailoring AMS implementation in Vietnam and other, similar settings. |
| first_indexed | 2024-03-07T01:29:26Z |
| format | Journal article |
| id | oxford-uuid:931aa7e1-487f-45bd-a076-6df00e7b243a |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T01:29:26Z |
| publishDate | 2020 |
| publisher | Oxford University Press |
| record_format | dspace |
| spelling | oxford-uuid:931aa7e1-487f-45bd-a076-6df00e7b243a2022-03-26T23:30:00ZFactors influencing choices of empirical antibiotic treatment for bacterial infections in a scenario-based survey in VietnamJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:931aa7e1-487f-45bd-a076-6df00e7b243aEnglishSymplectic ElementsOxford University Press2020Vu, TLHVu, QDHoang, BLNguyen, TCTTa, TDNNadjm, Bvan Doorn, HR<strong>Background</strong> Antimicrobial stewardship (AMS) programmes have been implemented around the world to guide rational use of antibiotics but implementation is challenging, particularly in low- and middle-income countries, including Vietnam. Understanding factors influencing doctors’ prescribing choices for empirical treatment can help design AMS interventions in these settings. <br> <strong>Objectives</strong> To understand doctors’ choices of antibiotics for empirical treatment of common bacterial infections and the factors influencing decision-making. <br> <strong>Methods</strong> We conducted a cross-sectional survey among medical professionals applying for a postgraduate programme at Hanoi Medical University, Vietnam. We used a published survey developed for internal medicine doctors in Canada. The survey was self-administered and included four clinical scenarios: (i) severe undifferentiated sepsis; (ii) mild undifferentiated sepsis; (iii) severe genitourinary infection; and (iv) mild genitourinary infection. <br> <strong>Results</strong> A total of 1011/1280 (79%), 683/1188 (57.5%), 718/1157 (62.1%) and 542/1062 (51.0%) of the participants selected combination therapy for empirical treatment in scenarios 1, 2, 3 and 4, respectively. Undifferentiated sepsis (OR 1.82, 95% CI 1.46–2.27 and 2.18, 1.51–3.16 compared with genitourinary) and severe infection (1.33, 1.24–1.43 and 1.38, 1.21–1.58 compared with mild) increased the likelihood of choosing a combination therapy and a carbapenem regimen, respectively. Participants with higher acceptable minimum threshold for treatment coverage and young age were also more likely to prescribe carbapenems. <br> <strong>Conclusions</strong> Decision-making in antibiotic prescribing among doctors in Vietnam is influenced by both disease-related characteristics and individual factors, including acceptable minimum treatment coverage. These findings are useful for tailoring AMS implementation in Vietnam and other, similar settings. |
| spellingShingle | Vu, TLH Vu, QD Hoang, BL Nguyen, TCT Ta, TDN Nadjm, B van Doorn, HR Factors influencing choices of empirical antibiotic treatment for bacterial infections in a scenario-based survey in Vietnam |
| title | Factors influencing choices of empirical antibiotic treatment for bacterial infections in a scenario-based survey in Vietnam |
| title_full | Factors influencing choices of empirical antibiotic treatment for bacterial infections in a scenario-based survey in Vietnam |
| title_fullStr | Factors influencing choices of empirical antibiotic treatment for bacterial infections in a scenario-based survey in Vietnam |
| title_full_unstemmed | Factors influencing choices of empirical antibiotic treatment for bacterial infections in a scenario-based survey in Vietnam |
| title_short | Factors influencing choices of empirical antibiotic treatment for bacterial infections in a scenario-based survey in Vietnam |
| title_sort | factors influencing choices of empirical antibiotic treatment for bacterial infections in a scenario based survey in vietnam |
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