ANTIBIOTIC RESISTANCE

92 Pages·2017·2.46 MB·English

Thesis for doctoral degree (Ph.D.)
2018
T
h ANTIBIOTIC RESISTANCE: IMPLICATIONS OF
e
sis fo
r d HOSPITAL PRACTICES FOR PUBLIC HEALTH
o
c
to
ral d A study from Hanoi, Vietnam
e
g
re
e
(P
h
.D
.) 2
0
1
8
AA
study from Hanoi, VietnamNTIBIOTIC RESISTANCE: IM
P
LIC
A
T
IO
N
S O
F H
O
SP
IT
A
L P
R
A
C
T
IC
E
S FO
R
P
U
B
LIC
H
E
A
LT
H

La Thi Quynh Lien
L
a
T
h
i Q
u
y
n
h
L
ie
n
From the Department of Public Health Sciences
Karolinska Institutet, Stockholm, Sweden
ANTIBIOTIC RESISTANCE: IMPLICATIONS OF
HOSPITAL PRACTICES FOR PUBLIC HEALTH
A study from Hanoi, Vietnam
La Thi Quynh Lien

Stockholm 2018
All previously published papers were reproduced with permission from the publisher.
Published by Karolinska Institutet.
Printed by E-Print AB
© La Thi Quynh Lien, 2018
ISBN 978-91-7676-928-7
Antibiotic resistance: implications of hospital
practices for public health
A study from Hanoi, Vietnam

THESIS FOR DOCTORAL DEGREE (Ph.D.)
By
La Thi Quynh Lien

Public Defence
Wednesday 21st March, 2018 at 10:00
Inghesalen, Tomtebodavägen 18A, Karolinska Institutet

Principal Supervisor: Opponent:
Professor Cecilia Stålsby Lundborg Associate Professor Björn Wettermark
Karolinska Institutet Karolinska Institutet
Department of Public Health Sciences, Department of Medicine, Clinical Epidemiology Unit
Global Health - Health Systems and Policy: Department of Laboratory Medicine, Clinical
Medicines, focusing antibiotics Pharmacology Unit

Co-supervisors:
Professor Ashok J. Tamhankar Examination Board:
R.D. Gardi Medical College, Ujjain, India Professor Katarina Hjelm
Department of Environmental Medicine Uppsala University
Affiliated researcher, Karolinska Institutet Department of Public Health and Caring Sciences,
Department of Public Health Sciences, Caring Sciences
Global Health - Health Systems and Policy:
Medicines, focusing antibiotics Associate Professor Ulrika Ransjö
Uppsala University
Associate Professor Nguyen Thi Kim Chuc Department of Medical Sciences, Clinical
Hanoi Medical University, Hanoi, Vietnam Microbiology
Department of Family Medicine
Associate Professor Åsa Sjöling
Doctor Nguyen Quynh Hoa Karolinska Institutet
Vietnam Ministry of Health, Hanoi, Vietnam Department of Microbiology, Tumor and Cell
National Centralized Drug Procurement Centre Biology

In the memory of my father

“Nothing in life is to be feared, it is only to be understood. Now is the time to understand
more, so that we may fear less.”
– Marie Curie

PREFACE
In 2001, I passed the entrance examination of Hanoi University of Pharmacy (HUP). My father,
who constantly encouraged me to study, was thrilled and held a party in celebration of my
success. During the first semester at HUP, I won a scholarship to study pharmacy at Saint
Petersburg State Chemical Pharmaceutical Academy, Russia. After being graduated from the
academy, I returned to Vietnam in 2008 and started working as a lecturer at HUP.
Being a junior lecturer at the only Vietnamese university specialised in training pharmacists,
where the cut-off score of the entrance examination has always been among the top universities
across the country, I did not feel "good enough". I strongly desired to be trained at a prestigious,
high-ranking university in the world.
It can be said that my PhD journey started during evening English classes, to times when my
scholarship applications for PhD programmes abroad were rejected, until I received a
scholarship from the Vietnamese Government to study PhD in Sweden. At the time, I was
fortunate to be involved in a research project aimed to strengthen the management of antibiotics
and antibiotic resistance in Vietnam led by Professor Cecilia Stålsby Lundborg, who later
became my principle supervisor.
Antibiotic resistance is a global challenge, particularly for low- and middle-income countries,
and requires global action. I hope this thesis will contribute, in part, to the provision of evidence
and respective solutions in the battle against antibiotic resistance globally.
Now that I am at the end of my PhD journey, I do not think that being “good enough” really
matters. I have learned and grown so much throughout this journey, not only in my professional
but also my personal life. For me, a big achievement on this journey is “understand more… and
fear less”.