Đánh giá việc sử dụng kháng sinh trên bệnh nhân suy thận tại Bệnh viện Đại học Y dược Thành phố Hồ Chí Minh

Abstract

Objective: To investigate antibiotic usage, appropriateness of dosing regimens, treatment outcomes, and renal toxicity related to antibiotic use among patients with renal impairment at University Medical Center Ho Chi Minh City (UMC HCMC). Subject and method: A descriptive cross-sectional study was performed on 372 patients diagnosed with renal impairment and indicated with at least one renally excreted antibiotic at UMC HCMC between 03/2021 and 12/2021. Appropriateness of dosing regimens was evaluated using the manufacturer’s instruction, Uptodate 2021, Sanford Guide 2021. Result: The median age of the study population was 77 (67-85) and female accounted for 57.0%. Beta-lactam (84.4%) and fluoroquinolone (41.4%) were the most commonly indicated classes of antibiotic. The proportion of appropriate dosing after adjustment was 66.1%. Male (OR: 4.308, 95%CI: 1.168-15.884, p=0.028), obesity (OR: 4.308, 95%CI: 1.168-15.884, p=0.028), indication of fosfomycin (OR: 0.187, 95%CI: 0.075-0.466, p<0.001), and indication of glycopeptide class (OR: 0.387, 95%CI: 0.205-0.730, p=0.003) were statistically associated with appropriate dosing of antibiotics. Successful treatment outcomes were observed in 86.6% of the study population and the incidence of renal toxicity was 7.5%. Conclusion: Results from the study suggests the need of enhancing dosing adjustment of antibiotics among patients with renal impairment in clinical settings.