Rational antibiotic use

Tünger, Özlem; Karakaya, Yeliz Arman; Çetin, Çiğdem Banu; Dinç, Gönül; Borand, Hakan

doi:10.3855/jidc.54

Cited by 58 publications

(64 citation statements)

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“…Disappointingly, a number of studies have reported inappropriate uses of antimicrobials as well as the emergence of antibiotic resistance in most parts of the world (Tunger et al, 2009; Bergman et al, 2006). Today, the emergence of multidrug-resistant (MDR) gramnegative and methicillin-resistant Staphylococcus aureus (MRSA) pathogens has become a major public health concern.…”

Section: Patients a D M I T T E D T O Intensive Care Units (Icus)mentioning

confidence: 99%

Antimicrobial susceptibility patterns among bacteria isolated from intensive care units of the largest teaching hospital at the northwest of Iran

Hamishehkar

Shadmehr

Mahmoodpoor

et al. 2016

Braz. J. Pharm. Sci.

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This study was conducted to determine the antimicrobial susceptibility patterns among common pathogens in the intensive care units (ICUs) of a university hospital in northwestern Iran. A retrospective study was done on laboratory records of patients with nosocomial infection who were admitted to five ICUs of Imam Reza Hospital during a 21-month period from March 2010 to January, 2012. A total number of 556 isolates from 328 patients were evaluated. The most common sites of infections included respiratory (51.7%), urinary (24.8%), and blood (10.4%). The most frequently isolated microorganisms were Enterobacter aerogenes (50.6%) followed by Escherichia coli (16.7%) and Pseudomonas aeruginosa (7.5%). Staphylococcus aureus was the most frequent pathogen among gram-positives (39.7%). The rate of methicillin-resistant Staphylococcus aureus (MRSA) was 87.5%. Multidrug-resistant (MDR) gram-negative bacteria were documented in 25.8% of Acinetobacter, 20% of Klebsiella, and 16.6% of Pseudomonas. The most active antimicrobials were vancomycin (93.5%) followed by amikacin (71.5%) and gentamicin (46%). The overall antibiotic susceptibility was as follows: 36% ciprofloxacin, 19% imipenem, 20% trimethoprim-sulfamethoxazole, 20.5% ceftazidime, and 12% ceftriaxone. Due to the high rate of antimicrobial resistance in the ICU setting, more surveillance and control of the use of antimicrobials is needed to combat infections. Uniterms:Intensive care units/anti-infective agents/cross infection. Hospital University/Iran. INTRODUCTION Patients a d m i t t e d t o intensive care units (ICUs)are more vulnerable to various nosocomial infections because of their underlying illnesses and exposure to various invasive medical devices (Jatin, Mary, 2012;Archibald et al., 1997;Fridkin, 2001;Kollef, Fraser, 2001;Rhomberg et al., 2006).Hospital infections affect approximately two million patients annually and lead to 90,000 deaths and a cost of $4.5 to $5.7 billion according to reports from the United States (Weinstein, 1998;Jarvis, 2001). They involve 5-10% of ICU patients (CDC, 1992;Stone, Larson, Kawar, 2002).Antibiotics are the mainstay tools in the management of infections. Disappointingly, a number of studies have reported inappropriate uses of antimicrobials as well as the emergence of antibiotic resistance in most parts of the world (Tunger et al., 2009; Bergman et al., 2006). Today, the emergence of multidrug-resistant (MDR) gramnegative and methicillin-resistant Staphylococcus aureus (MRSA) pathogens has become a major public health concern. Moreover, they negatively influence patients' outcomes and increase the length of hospital stays and healthcare costs (Giske et al., 2008;De Kraker et al., 2011;Resch, Wilke, Fink, 2009;Mulvey, Simor, 2009).Many studies have also showed that controlled use of antibiotics leads to improved microorganism sensitivity H. Hamishehkar, P. Shadmehr, A. Mahmoodpoor, S. O. Mashayekhi, T. Entezari-Maleki 404 to antimicrobial agents (Lee et al., 2010;Takesue et al., 2010). The emergence of resistant pathogens ...

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Section: Patients a D M I T T E D T O Intensive Care Units (Icus)mentioning

confidence: 99%

Antimicrobial susceptibility patterns among bacteria isolated from intensive care units of the largest teaching hospital at the northwest of Iran

Hamishehkar

Shadmehr

Mahmoodpoor

et al. 2016

Braz. J. Pharm. Sci.

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“…2001 yılı verilerine göre dün-yada ilk sırada (%19.3) kalp-damar sistemi ilaçları tüketilmiş-ken, aynı tarihte ülkemizde antibiyotiklerin ilk sırada (%18.1) tüketildiği görülmüştür (11) (12). Dünya Sağlık Örgütü verilerine göre değişik ülkelerdeki eğitim ve araştırma hastanelerinde uygunsuz antibiyotik kullanım oranı %45-90 olarak belirtilirken (13), ülkemizde bu oranın %40-60 arasında olduğu bildirilmektedir (2)(3)(4)14). Uygun kullanıldıklarında önemli yararlar sağlayan antibiyotikler, uygun kullanılmadığında tedavi maliyetini yükselterek ekonomik kayba yol açmakta, toksik yan etkiler gelişmekte, hızla dirençli suşlar ortaya çıkmakta ve dirençli suşlarla oluşan süperinfeksiyonlar morbidite ve mortalite oranlarında artışa neden olmaktadır (1,5,15).…”

Section: İrdelemeunclassified

“…Ülkemizde yatan hastalarda antibiyotik kullanım oranı %25-35 olup bu oran yoğun bakım ünitelerinde %50'nin üzerine çıkmaktadır ve bu olguların %40-60'ında akılcı olmayan kullanım söz konusudur (2)(3)(4).…”

Section: Introductionunclassified

The Efficacy of an Antibiotic Control Team on Rational Antibiotic Use: Cost-Utility Analysis and Achievement in Surgical Prophylaxis

Ulug¹,

Kemec²,

Uluğ³

2012

Klimik Dergisi

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ÖzetAmaç: Antibiyotikler dünyada olduğu gibi ülkemizde de en sık ve en hatalı kullanılan ilaçlardır. Çok sayıda çalışmada, hastanelerde uygunsuz antibiyotik kullanma oranının %40-60 düzeyinde olduğu gösterilmiştir. Antibiyotiklerin aşırı ve uygunsuz kullanımı dirençli bakterilerin ortaya çıkmasına, yan etkilerin, tedavi maliyetlerinin, morbidite ve mortalitenin artmasına neden olur. AbstractObjective: Antibiotics are the most frequently used drugs in our country, as being all over the world. It has been shown that the rate of inappropriate use of antibiotics is around 40% to 60% in hospitals. Excessive and inappropriate use of antibiotics causes emergence of resistant organisms, significant adverse effects, increased costs and increased morbidity and mortality. are defined as Period I and II, respectively. Antibiotics which were given to inpatients and for surgical prophylaxis were followed up. Subsequently, usage ratios of antibiotics in Period I and II were compared for a cost-utility analysis. Results: The total cost of inappropriate antibiotic use per year was calculated as 55 750.4 TL in our hospital. However, the most frequent cause of inappropriate use in surgical prophylaxis was related to prolonged use of prophylactic antibiotics (16.2%). Conclusions: Several strategies for regulating antimicrobial prescribing practices may be proposed, such as formulary replacement or restriction, healthcare provider education, feedback activities, and approval from an infectious diseases physician. However, a multidisciplinary antibiotic team organized for hospitals to approve the appropriate antibiotic use may be another alternative. Klimik Dergisi 2012; 25(1): 14-8.

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“…Morbidite ve mortaliteyi arttırmakta, ilaç ilişkili yan etkilere, hastanede yatış süresinin uzamasına, dirençli mikroorganizmaların oluşmasına neden olmakta ve tedavi maliyetlerini arttırmaktadır [5][6][7]. Uygunsuz antibiyotik kullanımı antibiyotiklerin serbestçe ulaşılabileceği marketlerin olması ve spesifik infeksiyonların daha sıklıkla görülmesi nedeni ile özellikle gelişmekte olan ülkelerde yaygın olarak görülmektedir [4,8].…”

Section: Introductionunclassified

Ayaktan takip ve tedavi edilen erişkin hastalarda akılcı antibiyotik kullanımı

Gözel¹

2012

CMJ

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Sistemik antibiyotiklerin önemli bir kısmı ayaktan başvuran ve poliklinik şartlarında takip ve tedavi edilen hastalarda kullanılmaktadır. Özellikle üst solunum yolu infeksiyonları gibi sıklıkla viral etkenler ile oluşan infeksiyonlarda antibiyotikler çeşitli nedenlerle yanlış kullanılmakta ve antimikrobiyal direnç gelişimine neden olmaktadır. Çoklu ilaç dirençli suşların oluşumu ve bu etkenlere bağlı gelişen infeksiyonlar günümüzde en önemli halk sağlığı problemlerinden birini oluşturmaktadır. Antimikrobiyal ilaçların akılcı ve uygun şekilde kullanımı bu ilaçlara karşı direnç gelişimini önlemede en önemli stratejilerden birini oluşturmaktadır.Anahtar sözcükler: Antibiyotik, akılcı antibiyotik kullanımı, antibiyotik direnci Abstract A significant part of the prescriptions of systemic antibiotics are made in patients who are treated in the outpatient setting. Although most outpatient respiratory tract infections that are caused primarily by viral pathogens do not require antimicrobial drug therapy, antibiotics are frequently prescribed. Inappropriate use of antibiotics is one of the most important factor affecting development of resistance to antimicrobial agents. The emergence of antibiotic resistant bacteria is a major public health problem throughout the world and rational use of antibiotics is therefore a very important. Strategy in preventin resistance against antibiotics.

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Rational antibiotic use

Cited by 58 publications

References 0 publications

Antimicrobial susceptibility patterns among bacteria isolated from intensive care units of the largest teaching hospital at the northwest of Iran

Antimicrobial susceptibility patterns among bacteria isolated from intensive care units of the largest teaching hospital at the northwest of Iran

The Efficacy of an Antibiotic Control Team on Rational Antibiotic Use: Cost-Utility Analysis and Achievement in Surgical Prophylaxis

Ayaktan takip ve tedavi edilen erişkin hastalarda akılcı antibiyotik kullanımı

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