ArticleJAC-antimicrobial resistance2026
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.
Article in JAC-antimicrobial resistance, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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20 authors.
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Abstract
Objectives: 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. Methods: 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). Results: 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. Conclusions: 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.
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