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Le LTT, Nguyen TA, Nguyen NA, Nguyen YTH, Nguyen HTB, Nguyen LT, Vi MT, Nguyen T. Helicobacter pylori Eradication Efficacy of Therapy Based on the Antimicrobial Susceptibility in Children with Gastritis and Peptic Ulcer in Mekong Delta, Vietnam. Children 2022; 9:children9071019. [PMID: 35884002 PMCID: PMC9324491 DOI: 10.3390/children9071019] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 07/03/2022] [Accepted: 07/04/2022] [Indexed: 11/16/2022]
Abstract
Background: The efficacy of Helicobacter pylori (H. pylori) eradication therapy for children is currently low, and antibiotic resistance is a significant cause of treatment failure. The purpose of this study was to evaluate the H. pylori eradication efficacy of therapy based on antimicrobial susceptibility in pediatric patients with gastritis and peptic ulcer. Methods: This study was conducted at Can Tho Children’s Hospital and Can Tho University of Medicine and Pharmacy Hospital between March 2019 and April 2022. We performed an upper gastrointestinal endoscopy, cultured H. pylori from biopsies of gastric mucosa, determined antibiotic sensitivities to H. pylori by the E-test method, and treated eradication based on the antibiotic susceptibilities of bacteria. After at least 4 weeks of eradication therapy, we assessed the effectiveness of treatment with a breath test. Results: Among 237 children recruited in this study, 48.9% were boys and 51.1% were girls, and the mean age was 10.03 ± 2.53 years. We determined that 80.6% of H. pylori were resistant to clarithromycin, as well as amoxicillin, metronidazole, levofloxacin, and tetracycline, at 71.7%, 49.4%, 45.1%, and 11.4%, respectively. The overall eradication rate of H. pylori was 83.1% (172/207). Among therapies tailored to antimicrobial susceptibility, the bismuth quadruple regimen achieved the greatest success, but the efficacy of triple therapy with esomeprazole + AMX + CLR/MTZ was low. Conclusions: Tailored eradication therapy was highly successful in our study but did not achieve over 90%. We recommend that in countries with a high prevalence of antibiotic resistance in H. pylori strains, particularly where the amoxicillin-resistance rate of H. pylori is high, therapy tailored to antimicrobial susceptibility should be used as first-line therapy, and bismuth and tetracycline should be added to enhance the eradication efficacy in children.
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Affiliation(s)
- Loan T. T. Le
- Department of Pediatrics, Can Tho University of Medicine and Pharmacy, Can Tho City 900000, Vietnam
- Correspondence: (L.T.T.L.); (T.N.)
| | - Tuan A. Nguyen
- Department of Pediatrics, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City 700000, Vietnam; (T.A.N.); (N.A.N.)
| | - Nghia A. Nguyen
- Department of Pediatrics, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City 700000, Vietnam; (T.A.N.); (N.A.N.)
| | - Yen T. H. Nguyen
- Department of Microbiology, Can Tho University of Medicine and Pharmacy, Can Tho City 900000, Vietnam; (Y.T.H.N.); (H.T.B.N.)
| | - Hai T. B. Nguyen
- Department of Microbiology, Can Tho University of Medicine and Pharmacy, Can Tho City 900000, Vietnam; (Y.T.H.N.); (H.T.B.N.)
| | - Liem T. Nguyen
- Faculty of Nursing and Medical Technology, Can Tho University of Medicine and Pharmacy, Can Tho City 900000, Vietnam;
| | - Mai T. Vi
- Department of Pharmacology and Clinical Pharmacy, Can Tho University of Medicine and Pharmacy, Can Tho City 900000, Vietnam;
| | - Thang Nguyen
- Department of Pharmacology and Clinical Pharmacy, Can Tho University of Medicine and Pharmacy, Can Tho City 900000, Vietnam;
- Correspondence: (L.T.T.L.); (T.N.)
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Nguyen LV, Pham LTT, Bui AL, Vi MT, Nguyen NK, Le TT, Pham ST, Nguyen PM, Nguyen TH, Taxis K, Nguyen T, Tran HD. Appropriate Antibiotic Use and Associated Factors in Vietnamese Outpatients. Healthcare (Basel) 2021; 9:healthcare9060693. [PMID: 34201175 PMCID: PMC8228789 DOI: 10.3390/healthcare9060693] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 06/04/2021] [Accepted: 06/06/2021] [Indexed: 01/21/2023] Open
Abstract
Background: Inappropriate antibiotic use among outpatients is recognized as the primary driver of antibiotic resistance. A proper understanding of appropriate antibiotic usage and associated factors helps to determine and limit inappropriateness. We aimed to identify the rate of appropriate use of antibiotics and identify factors associated with the inappropriate prescriptions. Methods: We conducted a cross-sectional descriptive study in outpatient antibiotic use at a hospital in Can Tho City, Vietnam, from August 1, 2019, to January 31, 2020. Data were extracted from all outpatient prescriptions at the Medical Examination Department and analyzed by SPSS 18 and Chi-squared tests, with 95% confidence intervals. The rationale for antibiotic use was evaluated through antibiotic selection, dose, dosing frequency, dosing time, interactions between antibiotics and other drugs, and general appropriate usage. Results: A total of 420 prescriptions were 51.7% for females, 61.7% with health insurance, and 44.0% for patients with one comorbid condition. The general appropriate antibiotic usage rate was 86.7%. Prescriptions showed that 11.0% and 9.5% had a higher dosing frequency and dose than recommended, respectively; 10.2% had an inappropriate dosing time; 3.1% had drug interactions; and only 1.7% had been prescribed inappropriate antibiotics. The risk of inappropriate antibiotic use increased in patients with comorbidities and antibiotic treatment lasting >7 days (p < 0.05). Conclusions: The study indicated a need for more consideration when prescribing antibiotics to patients with comorbidities or using more than 7 days of treatment.
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Affiliation(s)
- Lam V. Nguyen
- Department of Anatomy, Can Tho University of Medicine and Pharmacy, Can Tho City 900000, Vietnam;
| | - Lien T. T. Pham
- Department of Medicinal Chemistry, Can Tho University of Medicine and Pharmacy, Can Tho 900000, Vietnam;
| | - Anh L. Bui
- Department of Pharmacology and Clinical Pharmacy, Can Tho University of Medicine and Pharmacy, Can Tho City 900000, Vietnam; (A.L.B.); (M.T.V.); (N.K.N.); (S.T.P.); (T.N.)
| | - Mai T. Vi
- Department of Pharmacology and Clinical Pharmacy, Can Tho University of Medicine and Pharmacy, Can Tho City 900000, Vietnam; (A.L.B.); (M.T.V.); (N.K.N.); (S.T.P.); (T.N.)
| | - Nguyet K. Nguyen
- Department of Pharmacology and Clinical Pharmacy, Can Tho University of Medicine and Pharmacy, Can Tho City 900000, Vietnam; (A.L.B.); (M.T.V.); (N.K.N.); (S.T.P.); (T.N.)
| | - Tam T. Le
- Can Tho University of Medicine and Pharmacy Hospital, Can Tho City 900000, Vietnam;
| | - Suol T. Pham
- Department of Pharmacology and Clinical Pharmacy, Can Tho University of Medicine and Pharmacy, Can Tho City 900000, Vietnam; (A.L.B.); (M.T.V.); (N.K.N.); (S.T.P.); (T.N.)
| | - Phuong M. Nguyen
- Department of Pediatrics, Can Tho University of Medicine and Pharmacy, Can Tho City 900000, Vietnam;
| | - Thao H. Nguyen
- Department of Clinical Pharmacy, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City 700000, Vietnam;
| | - Katja Taxis
- Groningen Research Institute of Pharmacy, University of Groningen, 9713 AV Groningen, The Netherlands;
| | - Thang Nguyen
- Department of Pharmacology and Clinical Pharmacy, Can Tho University of Medicine and Pharmacy, Can Tho City 900000, Vietnam; (A.L.B.); (M.T.V.); (N.K.N.); (S.T.P.); (T.N.)
| | - Hung D. Tran
- Faculty of Nursing, Can Tho University of Medicine and Pharmacy, Can Tho City 900000, Vietnam
- Correspondence:
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