Antimicrobial use for the management of varicella in Thailand: a retrospective observational study
1
Issued Date
2023-01-01
Resource Type
ISSN
03007995
eISSN
14734877
Scopus ID
2-s2.0-85158148230
Pubmed ID
37057414
Journal Title
Current Medical Research and Opinion
Rights Holder(s)
SCOPUS
Bibliographic Citation
Current Medical Research and Opinion (2023)
Suggested Citation
Chokephaibulkit K., Samant S., Chaisavaneeyakorn S., Kamolratanakul S., Limpadanai S., Kebede N., Stephens J., Sukarom I., Pawaskar M. Antimicrobial use for the management of varicella in Thailand: a retrospective observational study. Current Medical Research and Opinion (2023). doi:10.1080/03007995.2023.2200123 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/82474
Title
Antimicrobial use for the management of varicella in Thailand: a retrospective observational study
Other Contributor(s)
Abstract
Objective: To describe the clinical characteristics of varicella patients seeking medical consultation and the use of antimicrobials for their management in Thailand in the absence of universal varicella vaccination (UVV). Methods: A multicenter, retrospective chart review of 260 children and adults with a primary diagnosis of varicella was conducted at one private and three public hospitals in Bangkok, Thailand. Charts of varicella patients (inpatient or outpatient) were randomly selected over a 5-year period. Key outcomes included clinical complications and the use of antibiotics, antivirals, and other medications. Results: Charts of 200 children (mean age 5.7 years, range 0.3–16 years) and 60 adults (mean age 27.9 years, range 18–50 years) were reviewed. Fourteen patients (including 8 children) were hospitalized. Five percent of the children and none of the adults were immunocompromised. At least 1 varicella-related complication was reported by 7.3% (7% of children, 8.3% of adults, p =.778) of all patients, including 57.1% (62.5% of children, 50% of adults) of inpatients (p <.001, compared with outpatients). Skin/soft tissue infection (47.7%) and dehydration (47.4%) were the most common complications. Antivirals (mainly oral acyclovir) were prescribed to 46.5% of patients (31.5% of children, 96.7% of adults, p <.001). Antibiotics were prescribed to 20.8% of patients (19% of children, 26.7% of adults, p =.199). Topical, oral, and intravenous antibiotics were prescribed to 12.3%, 8.5%, and 1.2% of patients, respectively. Antimicrobial prescriptions were higher among adults (p <.001) and immunocompromised patients (p =.025). Apart from antimicrobials, acetaminophen (62.3%) and oral antihistamines (51.5%) were the most prescribed. Conclusion: A considerable number of varicella patients, both children and adults, seeking medical consultation in Thai hospitals are prescribed antibiotics and antivirals, with one-fifth of patients being prescribed an antibiotic and almost half prescribed an antiviral. The study may be of interest to policymakers in Thailand and other Asia-Pacific countries considering UVV implementation.