1741. Antibiotic Prescribing Practices in Pediatric Acute Respiratory Illnesses in Northern Vietnam

Abstract

Abstract Background Antimicrobial resistance (AMR) is a global challenge and influenced by several factors including antibiotic overprescribing. Antibiotics are frequently prescribed in Vietnam, especially in pediatric acute respiratory illnesses (ARIs). Understanding prescribing practices for pediatric ARIs is important to help identify areas for improved practices to prevent overprescribing and AMR. Methods We performed a retrospective review of pediatric patients aged 0-15 years with an ARI diagnosis based on ICD-10 codes from January 1-December 31, 2019 in 112 primary care centers in Northern Vietnam. Variables collected included age, sex, district, antibiotic prescribed, World Health Organization access, watch, reserve classification (WHO AWaRe), symptomatic agents prescribed, and signs and symptoms. Data was analyzed using descriptive statistical analysis. Results A total of 35,679 encounters were reviewed. Of all encounters, 34,018 (95.3%) received antibiotics, and 1,650 (4.9%) of these received >1 antibiotic (Table 1). According to WHO AWaRe classification, 19.3% of children 0 to < 5 years received a watch antibiotic compared to 10.4% in those 5 to15 years. The most frequent diagnosis was acute pharyngitis (21,270 encounters, 59.6%) and 20,496 (96.4%) of those encounters received antibiotics. Common signs and symptoms reported included cough (76.3%), fever (40.9%), and erythematous pharynx (33.1%). Though acute pharyngitis was the most common diagnosis, only 168 (0.5%) and 59 (0.2%) of encounters described lymphadenopathy and exudate, respectively. Conclusion Antibiotics are frequently prescribed for pediatric ARIs in Northern Vietnam. Most antibiotics prescribed were WHO AWaRe access antibiotics; however, 14% were watch antibiotics or not recommended. Though acute pharyngitis was the most common diagnosis, only a few of the encounters reported signs or symptoms that would be more suggestive of acute bacterial pharyngitis warranting antibiotics. Further investigation of the appropriateness of antibiotic prescriptions are needed to help identify targeted areas of improvement in prescribing practices and help decrease the burden of AMR. Disclosures Daniel Olson, MD, Pfizer: Grant/Research Support|Roche: Grant/Research Support.