Rational antibiotic use is a pillar in medical examination and treatment. This ensures safety for patients. Simultaneously, it helps prevent antimicrobial resistance.
This article is based on Decision 5631/QĐ-BYT. Medical facilities need to establish strict management regulations. This is based on the classification of drug priority levels.
Principles for establishing the antibiotic list
The Antibiotic Stewardship Unit needs to coordinate with the Pharmacy and Therapeutics Committee. They will jointly establish an antibiotic list for the hospital. This list must be suitable for the disease pattern. It also needs to align with the microbiological situation at the unit. According to Decision 5631/QĐ-BYT, the drug list needs to be clearly divided. Below are specific management groups.
Group 1: Antibiotics requiring priority management
This is the most strictly controlled group. They are usually special reserve antibiotics. Or drugs with a very high risk of resistance.
The core regulation of this group is “Pre-authorization”. Doctors wishing to prescribe must perform a consultation. Then, they complete an Antibiotic Use Request Form. This form needs approval from the Stewardship Team or an authorized person.
This process can be flexible in emergencies. Doctors are allowed to administer the drug first. The dossier will be completed within 24 – 48 hours. Regulations may also vary in some specific departments. For example, Intensive Care Units or Infectious Diseases departments.
Group 2: Antibiotics of concern
This group includes drugs with a high risk of generating resistance. Or drugs with a broad antibacterial spectrum. Examples include 3rd and 4th generation Cephalosporins or Carbapenems.
The hospital needs to closely monitor the consumption level of this group. The resistance rate also needs to be monitored closely. The hospital may restrict the category of prescribing doctors. Decentralization can be based on specialty or seniority. This ensures drugs are used for the right target and economically.
Building guidelines for infection treatment
Hospitals are mandatory to have professional guidelines on antibiotic use. These guidelines apply to common infectious diseases. It covers both empirical and targeted treatment.
The content of the guidelines needs to detail dosage and route of administration. Treatment duration must also be clearly prescribed. Especially, emphasis should be placed on the antibiotic de-escalation process. The switch from intravenous to oral administration is very important.
Regulations on surgical prophylaxis antibiotics
The hospital needs specific procedures for each type of surgery. The regulations need to clarify the chosen antibiotic type. The timing of drug administration is usually 60 minutes before skin incision.
The time to stop the drug also needs to be controlled. Typically no more than 24 hours post-surgery. Adhering to this helps minimize surgical site infections. At the same time, it avoids waste and prevents drug resistance.
Compliance with Decision 5631/QĐ-BYT is a prerequisite step. It helps the hospital improve treatment quality. Antibiotic resources will also be protected for the future.
Assoc. Prof. Dr. La Ngoc Quang – Center for Support & Continuing Education