HANEFİ CEM GÜL, CUMHUR ARTUK, Gürkan MERT, Gamze Özbek GÜVEN, Selim KILIÇ, Can Polat EYİGÜN

Türkiye'de bir üniversite hastanesinde antibiyotik kullanımı ve uygunluğu: 2012-2013 yılları nokta prevalans sonuçlarının karşılaştırılması

AMAÇ: Bu çalışma; 1200 yataklı bir üniversite hastanesinde birer yıl arayla yapılan nokta prevalans çalışmalarının karşılaştırılması amaçlanmıştır. YÖNTEM: Çalışmada; 20 Nisan 2012 ve 19 Nisan 2013 tarihlerinde hastanemizde yatan tüm hastaların antibiyotik kullanımları nokta prevalans yöntemi ile değerlendirildi. Antibiyotik kullanım nedenleri ampirik, enfeksiyon tanısı, profilaktik olarak gruplara ayrıldı. Veriler bilgisayar ortamına aktarıldı ve SPSS 15.0 paket programı ile analizleri yapıldı. Non-parametrik verilerin karşılaştırılması için ki-kare yöntemi kullanıldı. p

[Antibiotic usage and appropriateness for a university hospital in Turkey: comparison of the results of the point prevalence in 2012-2013]

AIM: This study aims to compare point prevalence results which were done with one year interval in a university hospital with a 1,200-bed capacity. METHODS: The study assessed antibiotic usage among all hospitalised patients in the hospital on April 20, 2012 and April 19, 2013, using the point prevalence method. The assessment was carried out by an infectious disease specialist relying on the basic principles of antibiotic usage and current antimicrobial treatment guides. The causes of antibiotic usage were classified under three groups, namely, empirical, infection diagnosis and prophylactic. Data were transferred to computer and analysed using SPSS 15.0. We used the chi square method for comparisons of categorical variables. P values <0.05 were considered to be statistically significant. RESULTS: When rate of patients used antibiotic is examined, the rate of 2012 (39.3%, 262/66) is found similar by comparing 2013's rate (36.7%, 249/678). At distribution of antibiotic usage rate according to wards, statistically significantly reduction is observed in pediatric wards (p<0.001; 2102: 90.5%, 2013: 37.8%). While appropriateness of usage indications increased from 55.7% to 69.8%, inappropriateness usage rate decreased from 44.3% to 30.2% (p<0.001). Inappropriateness rate of infection diagnosis usage declined from 15,8% to 4.7%. Particularly, appropriateness rate of empiric usage soared from 48% to 65% and it was found to be statistically significant. Appropriateness rate of empiric usage increased from 13.3% to 44.5% (p<0.05) on surgical wards, while inappropriateness rate of infection diagnosed usage diminished from 22% to 5.9% on medical wards (p<0.017). When the frequency of causes of infection was compared, 6 patients used antibiotic due to prosthetic infection dropped to zero and the usage for diabetic foot infection risen to 13 from 3 (p<0.05). Fluoroquinolone usage for prophylaxis statistically significantly reduced (from 23.2% to 7.4%; p<0.008) and carbepem usage soared (from 14.9% to 29.4%; p<0.017). CONCLUSıON: Especially, increased inappropriate prophylactic antibiotic usage rates in surgical wards has been decreased by reinforming the surgeons regarding prophylactic antibiotic usage and providing with obeying the surgical prophylaxis guidelines.

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