ArticleThe Lancet regional health. Western Pacific2025
The effect of antimicrobial stewardship interventions upon antimicrobial consumption and appropriateness in Vietnamese district hospitals: a cluster randomised trial.
Article in The Lancet regional health. Western Pacific, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Factors influencing antimicrobial stewardship implementation in healthcare facilities in four countries of Southeast Asia: a mixed-methods study (2022-23).The Lancet regional health. Southeast Asia · 2026Article
- Context-specific impact of antimicrobial stewardship on antibiotic use and antibiotic resistance in hospitals in a lower-middle-income country: results from an implementation study with a controlled interrupted time series design in Viet Nam.JAC-antimicrobial resistance · 2026Article
- Antimicrobial Stewardship Program in a Low-Middle Income Country: Impact of an Antibiotic Guideline for Neonatal Early-Onset Sepsis.Antibiotics (Basel, Switzerland) · 2026Article
- Mapping antimicrobial resistance interventions in ASEAN countries: a scoping review of implementation patterns, One Health integration, and evidence gaps.Tropical medicine and health · 2026Review
- Antimicrobial Consumption and Resistance Dynamics Across Healthcare Level: Global Evidence and Stewardship Implications.Pathogens (Basel, Switzerland) · 2026Review
- Carriage of multidrug-resistant bacteria and encoding genes among Vietnamese children with acute diarrhea.IJID regions · 2026Article
- Genotype-Phenotype Links Between Aminoglycoside-Modifying Enzymes and Aminoglycoside MICs in Aminoglycoside-ResistantMicroorganisms · 2026Article
- Article
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Authors and funding
18 authors.
Funding
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Abstract
Background: Inappropriate antimicrobial use is a key driver of antimicrobial resistance. Antimicrobial stewardship (AMS) promotes the judicious use of antimicrobials to address this problem. This study evaluated the effect of an AMS program on antimicrobial prescribing practices in district hospitals in Vietnam. Methods: A cluster randomised controlled trial was conducted in 16 district hospitals in northern and southern Vietnam over four months. Hospitals were randomly assigned to intervention or control groups. Interventions included establishing AMS committees and teams, distributing antimicrobial guidelines, training healthcare workers, providing patient educational material, and conducting periodic audits with feedback on antimicrobial prescribing. Co-primary outcomes were the "difference in differences" in (i) total antimicrobial consumption and (ii) inappropriate prescribing according to standardised guidelines, before and after the intervention, between intervention and control groups. Secondary outcomes included antimicrobial costs and all-cause mortality. After the intervention period, control sites also received the AMS program. Trial registry: Australia and New Zealand Clinical Trials Registry (ANZCTR) number 12622000715774. Findings: A total of 877 and 1220 antimicrobial prescriptions were reviewed in intervention hospitals, and 1277 and 1454 prescriptions in control hospitals at baseline and post-intervention. Inappropriate antimicrobial prescribing exceeded 60% in each hospital at baseline. After the intervention, inappropriate prescribing in the intervention group reduced by 6.3% (95% CI -10.9%, -1.7%) relative to the control group. Total antimicrobial consumption did not differ between groups, but antimicrobial costs reduced in the intervention group. No difference in all-cause mortality was observed. Interpretation: AMS interventions modestly reduced inappropriate antimicrobial prescribing in district hospitals in Vietnam, underscoring the importance of AMS in resource-limited settings. Funding: The Australian Department of Foreign Affairs and Trade.
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