{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T14:56:35Z","timestamp":1767192995778,"version":"3.48.0"},"reference-count":35,"publisher":"BMJ","issue":"8","license":[{"start":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T00:00:00Z","timestamp":1754352000000},"content-version":"unspecified","delay-in-days":4,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["JP21wm0125006"],"award-info":[{"award-number":["JP21wm0125006"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]},{"name":"The Japan Foundation for Pediatric Research"},{"DOI":"10.13039\/501100001691","name":"KAKENHI","doi-asserted-by":"crossref","award":["23K18396"],"award-info":[{"award-number":["23K18396"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001691","name":"KAKENHI","doi-asserted-by":"crossref","award":["23K27865"],"award-info":[{"award-number":["23K27865"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100003478","name":"Ministry of Health, Labour and Welfare","doi-asserted-by":"publisher","award":["23HA1004"],"award-info":[{"award-number":["23HA1004"]}],"id":[{"id":"10.13039\/501100003478","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,7,16]]},"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study aimed to investigate the characteristics and management of influenza-like illnesses (ILIs) in the outpatient and inpatient settings in Vietnam.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A cross-sectional, observational study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting and participants<\/jats:title>\n                    <jats:p>We conducted a questionnaire survey of 407 individuals with ILI symptoms who presented to public community health centres and the paediatric ward of a public hospital in the city of Nha Trang, Khanh Hoa Province, Vietnam, from December 2022 to March 2023.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>Not applicable.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>No primary and secondary outcomes were pre-specified because this study was an explanatory study. The basic characteristics of the participants are presented using descriptive statistics. We conducted multivariable logistic regression analysis to examine the factors associated with the prescription of antibiotics to outpatients with ILIs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 198 outpatients and 200 inpatients were enrolled in the study. Most inpatients were children under 5 years of age and experienced longer illness durations and higher costs, with almost all patients receiving antibiotics. The rate of antimicrobial prescription for ILIs was 79.3% for outpatients and 99.5% for inpatients. The median health-related quality of life score of participants aged \u226518 years during illness was 0.796 (IQR 0.674\u20130.922). Logistic regression analysis indicated a negative association between a definite diagnosis of viral infection by rapid diagnostic test and outpatient antibiotic prescription (OR: 0.20, p=0.006).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study underscores the widespread inappropriate antimicrobial use for ILIs in a community in Vietnam, which contributes to an avoidable economic and health burden. The results of this study suggest that implementing diagnostic tools may support antimicrobial stewardship efforts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-094949","type":"journal-article","created":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T18:25:28Z","timestamp":1754418328000},"page":"e094949","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Antimicrobial use for influenza-like illnesses in Nha Trang, Vietnam: a cross-sectional study"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5732-846X","authenticated-orcid":false,"given":"Shinya","family":"Tsuzuki","sequence":"first","affiliation":[{"name":"Japan Institute for Health Security National Center for Global Health and Medicine, Shinjuku, Japan"},{"name":"Department of Pediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan"},{"name":"Vaccine & Infectious Disease Institute, University of Antwerp, Antwerpen, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hien-Anh Thi","family":"Nguyen","sequence":"additional","affiliation":[{"name":"National Institute of Hygiene and Epidemiology, Hanoi, Viet Nam"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michiko","family":"Toizumi","sequence":"additional","affiliation":[{"name":"Department of Pediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hien Minh","family":"Vo","sequence":"additional","affiliation":[{"name":"Khanh Hoa General Hospital, Nha Trang, Viet Nam"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hoang Huy","family":"Le","sequence":"additional","affiliation":[{"name":"National Institute of Hygiene and Epidemiology, Hanoi, Viet Nam"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Duc Anh","family":"Dang","sequence":"additional","affiliation":[{"name":"National Institute of Hygiene and Epidemiology, Hanoi, Viet Nam"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philippe","family":"Beutels","sequence":"additional","affiliation":[{"name":"Vaccine & Infectious Disease Institute, University of Antwerp, Antwerpen, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7567-3248","authenticated-orcid":false,"given":"Lay Myint","family":"Yoshida","sequence":"additional","affiliation":[{"name":"Department of Pediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,8,5]]},"reference":[{"key":"2025123106452266000_15.8.e094949.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)33293-2"},{"key":"2025123106452266000_15.8.e094949.2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)32335-3"},{"key":"2025123106452266000_15.8.e094949.3","unstructured":"Centers for Disease Control and Prevention . Influenza. 2017."},{"key":"2025123106452266000_15.8.e094949.4","unstructured":"World Health Organization . Global Action Plan on Antimicrobial Resistance. 2015."},{"key":"2025123106452266000_15.8.e094949.5","unstructured":"World Health Organization . Vietnam: National action plan for combating drug resistance, Available: https:\/\/www.who.int\/publications\/m\/item\/vietnam-national-action-plan-for-combating-drug-resistance"},{"key":"2025123106452266000_15.8.e094949.6","doi-asserted-by":"crossref","first-page":"i26","DOI":"10.1093\/jac\/dkac214","article-title":"Country data on AMR in Vietnam in the context of community-acquired respiratory tract infections: links between antibiotic susceptibility, local and international antibiotic prescribing guidelines, access to medicines and clinical outcome","volume":"77","author":"Torumkuney","year":"2022","journal-title":"J Antimicrob Chemother"},{"key":"2025123106452266000_15.8.e094949.7","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1080\/03007995.2019.1700947","article-title":"Ongoing strategies to improve the management of upper respiratory tract infections and reduce inappropriate antibiotic use particularly among lower and middle-income countries: findings and implications for the future","volume":"36","author":"Godman","year":"2020","journal-title":"Curr Med Res Opin"},{"key":"2025123106452266000_15.8.e094949.8","doi-asserted-by":"crossref","DOI":"10.1186\/s12913-020-5021-1","article-title":"Cost of inappropriate antimicrobial use for upper respiratory infection in Japan","volume":"20","author":"Tsuzuki","year":"2020","journal-title":"BMC Health Serv Res"},{"key":"2025123106452266000_15.8.e094949.9","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkx504"},{"key":"2025123106452266000_15.8.e094949.10","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkx502"},{"key":"2025123106452266000_15.8.e094949.11","doi-asserted-by":"publisher","DOI":"10.7326\/M16-1131"},{"key":"2025123106452266000_15.8.e094949.12","doi-asserted-by":"crossref","DOI":"10.7189\/jogh.10.010360","article-title":"Antimicrobial resistance and over the counter use of drugs in Nepal","volume":"10","author":"Pokharel","year":"2020","journal-title":"J Glob Health"},{"key":"2025123106452266000_15.8.e094949.13","doi-asserted-by":"crossref","DOI":"10.1136\/bmjgh-2021-005829","article-title":"Why do people purchase antibiotics over-the-counter? A qualitative study with patients, clinicians and dispensers in central, eastern and western Nepal","volume":"6","author":"Adhikari","year":"2021","journal-title":"BMJ Glob Health"},{"key":"2025123106452266000_15.8.e094949.14","article-title":"Outpatient antibiotic prescribing for acute respiratory infections in Vietnamese primary care settings by the WHO AWaRe (Access, Watch and Reserve) classification: An analysis using routinely collected electronic prescription data","volume":"30","author":"Nguyen","year":"2023","journal-title":"Lancet Reg Health West Pac"},{"key":"2025123106452266000_15.8.e094949.15","doi-asserted-by":"crossref","first-page":"1329","DOI":"10.1111\/jpc.14413","article-title":"Paediatric use of antibiotics in children with community acquired pneumonia: A survey from Da Nang, Vietnam","volume":"55","author":"Nguyen","year":"2019","journal-title":"J Paediatr Child Health"},{"key":"2025123106452266000_15.8.e094949.16","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2018-028224","article-title":"Antibiotic knowledge, attitudes and practices: new insights from cross-sectional rural health behaviour surveys in low-income and middle-income South-East Asia","volume":"9","author":"Haenssgen","year":"2019","journal-title":"BMJ Open"},{"key":"2025123106452266000_15.8.e094949.17","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dky031"},{"key":"2025123106452266000_15.8.e094949.18","unstructured":"WHO . Revision of clinical case definitions: influenza-like illness and severe acute respiratory infection, Available: http:\/\/www.who.int\/bulletin\/volumes\/96\/2\/17-194514\/en\/"},{"key":"2025123106452266000_15.8.e094949.19","doi-asserted-by":"crossref","DOI":"10.1097\/00005650-199603000-00003","article-title":"A 12-Item Short-Form Health Survey: Construction of Scales and Preliminary Tests of Reliability and Validity","volume":"34","author":"Ware","year":"1996","journal-title":"Med Care"},{"key":"2025123106452266000_15.8.e094949.20","unstructured":"R Core Team . 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Regional Office for the Western Pacific . Influenza Situation Updates 2023. 2023."}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2024-094949","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T14:45:44Z","timestamp":1767192344000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2024-094949"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8]]},"references-count":35,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2025,8,5]]},"published-print":{"date-parts":[[2025,8]]}},"alternative-id":["10.1136\/bmjopen-2024-094949"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2024-094949","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"type":"print","value":"2044-6055"},{"type":"electronic","value":"2044-6055"}],"subject":[],"published":{"date-parts":[[2025,8]]}}}