Paper Information

Regarding antibiotic use, the intervention was associated with an immediate absolute reduction of 95.9 DOT/1000 patient-days (95%CI 10.9-180.8) in Hospital 1, while Hospital 2 showed no overall change but declining slopes in selected antibiotics including aminoglycosides and penicillin/beta-lactamase inhibitors. Escherichia coli showed decreasing non-susceptibility to aminoglycosides and third-generation cephalosporins in both hospitals. Carbapenem non-susceptibility increased for both E. coli and Klebsiella spp. in Hospital 2 but decreased for Klebsiella spp. in Hospital 1. Non-susceptibility of P. aeruginosa increased to carbapenems (Hospital 1), aminoglycosides, ciprofloxacin and ceftazidime (Hospital 2). Acinetobacter spp. showed increased non-susceptibility to aminoglycosides and piperacillin-tazobactam in Hospital 1 but decreased to carbapenems, ciprofloxacin and piperacillin-tazobactam in Hospital 2. No evidence of changes in mortality or hospitalization costs were observed in both hospitals.

The impact of AMS varied between the two hospitals, highlighting the context-specific nature of implementation. Sustained monitoring of antibiotic use and resistance is needed to support locally tailored interventions that respond to evolving resistance epidemiology.

We performed controlled interrupted time-series analyses to evaluate the intervention effects on antibiotic use in days of therapy (DOT) per 1000 patient-days, antibiotic non-susceptibility percentage and patient outcomes. In each hospital, four wards received the intervention, and four wards acted as controls. Pre-intervention periods began in January 2019 and continued to May 2020 (Hospital 1) and July 2020 (Hospital 2).

We aimed to determine the effects of a 12-month antimicrobial stewardship (AMS) programme in two provincial-level general hospitals in Viet Nam, a lower-middle-income country.