Antibiotic use and resistance in emerging economies: A situation analysis for Viet Nam

Kinh Van Nguyen, Nga Thuy Thi Do, Arjun Chandna, Trung Vu Nguyen, Ca Van Pham, Phuong Mai Doan, An Quoc Nguyen, Chuc Kim Thi Nguyen, Mattias Larsson, Socorro Escalante, Babatunde Olowokure, Ramanan Laxminarayan, Hellen Gelband, Peter Horby, Ha Bich Thi Ngo, Mai Thanh Hoang, Jeremy Farrar, Tran Tinh Hien, Heiman Fl Wertheim

Research output: Contribution to journalArticlepeer-review

137 Scopus citations


Background: Antimicrobial resistance is a major contemporary public health threat. Strategies to contain antimicrobial resistance have been comprehensively set forth, however in developing countries where the need for effective antimicrobials is greatest implementation has proved problematic. A better understanding of patterns and determinants of antibiotic use and resistance in emerging economies may permit more appropriately targeted interventions.Viet Nam, with a large population, high burden of infectious disease and relatively unrestricted access to medication, is an excellent case study of the difficulties faced by emerging economies in controlling antimicrobial resistance. Methods. Our working group conducted a situation analysis of the current patterns and determinants of antibiotic use and resistance in Viet Nam. International publications and local reports published between 1-1-1990 and 31-8-2012 were reviewed. All stakeholders analyzed the findings at a policy workshop and feasible recommendations were suggested to improve antibiotic use in Viet Nam.Here we report the results of our situation analysis focusing on: the healthcare system, drug regulation and supply; antibiotic resistance and infection control; and agricultural antibiotic use. Results: Market reforms have improved healthcare access in Viet Nam and contributed to better health outcomes. However, increased accessibility has been accompanied by injudicious antibiotic use in hospitals and the community, with predictable escalation in bacterial resistance. Prescribing practices are poor and self-medication is common - often being the most affordable way to access healthcare. Many policies exist to regulate antibiotic use but enforcement is insufficient or lacking.Pneumococcal penicillin-resistance rates are the highest in Asia and carbapenem-resistant bacteria (notably NDM-1) have recently emerged. Hospital acquired infections, predominantly with multi-drug resistant Gram-negative organisms, place additional strain on limited resources. Widespread agricultural antibiotic use further propagates antimicrobial resistance. Conclusions: Future legislation regarding antibiotic access must alter incentives for purchasers and providers and ensure effective enforcement. The Ministry of Health recently initiated a national action plan and approved a multicenter health improvement project to strengthen national capacity for antimicrobial stewardship in Viet Nam. This analysis provided important input to these initiatives. Our methodologies and findings may be of use to others across the world tackling the growing threat of antibiotic resistance.

Original languageEnglish (US)
Article number1158
JournalBMC Public Health
Issue number1
StatePublished - Dec 10 2013
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Public Health, Environmental and Occupational Health


  • Antibiotic consumption
  • Antibiotic resistance
  • Bacterial diseases
  • Health policy
  • Health systems
  • Legislation (health)
  • Resource constrained


Dive into the research topics of 'Antibiotic use and resistance in emerging economies: A situation analysis for Viet Nam'. Together they form a unique fingerprint.

Cite this