ÜST SOLUNUM YOLU İNFEKSİYONLARININ AMPİRİK TEDAVİSİNİN PLANLAMASINDA ANTİMİKROBİYAL DİRENÇ: TÜRKİYE VE DÜNYADAKİ MEVCUT DURUM VE MÜCADELE STRATEJİLERİ

Antimikrobiyal direnç (AMD) kötü klinik sonuçlar, artmış rekürren infeksiyon ve ölüm riski nedeniyle çok önemli, dünya genelinde prevalansı hızla artan bir sorundur. Son yıllarda aşırı ve akılcı olmayan antibakteriyel kullanımına bağlı artan direnç gelişimi sorununa karşın gelişen teknolojiye rağmen yeni bir antibakteriyel ilaç kullanıma alınamamıştır. Bu durum AMD probleminin hızla büyümesine neden olmaktadır. Türkiye ESAC-Net kapsamındaki tüm Avrupa ülkeleri arasında en yüksek oranda antibakteriyel ilaç kullanımına sahip ülke konumundadır. Solunum yolu infeksiyonları oldukça yaygın ve yüksek antibiyotik kullanım oranları açısından hastane kaynaklı infeksiyonlarda olduğu kadar, toplum kaynaklı infeksiyonların tedavisi için de süregiden bir sorun ve AMD önleme stratejileri için zorlu bir alandır. Gerek birinci basamak gerekse hastane düzeyinde aşırı ve akılcı olmayan antibiyotik kullanımının önüne geçilmesi için alınacak tedbirlerin AMD ile mücadelede rolü büyüktür. Bu derlemede, üst solunum yolu infeksiyonlarının ampirik tedavisinin planlamasında genelde göz ardı edilen AMD, Türkiye ve dünyadaki mevcut durum ve mücadele stratejileri açısından ele alınacaktadır.

Antimicrobial Resistance in the Planning of the Empirical Therapy of Upper Respiratory Tract Infections: Current Situation and Treatment Strategies in Turkey and in the World

Antimicrobial resistance (AMR) is a very important problem with increasing prevalence worldwide and poor clinical outcomes due to recurrent infections and risk of death. In spite of the increased development of antibiotic resistance due to excessive and irrational antibacterial use in recent years, a new antibacterial drug has not been developed despite the developing new technologies. This situation causes rapidly growing AMR problem. As a country among all ESAC-net European countries, Turkey has the highest rate of antibacterial drug use. Respiratory tract infections are a common problem in terms of high prevalence and high rates of antibiotic use, as well as an ongoing problem for the treatment of community-acquired and hospital-acquired infections and represent a challenge for AMR prevention strategies. Approaches to prevent excessive and irrational use of antibiotics at both the primary and hospital levels have a significant role in combating AMR. In this review, AMR which is generally ignored in the planning of empirical treatment of upper respiratory tract infections will be evaluated in terms of the current situation and strategies to combat, in Turkey and in the world.

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