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Ayaktan takip ve tedavi edilen erişkin hastalarda akılcı antibiyotik kullanımı

Yıl 2012, Cilt: 34 Sayı: 4, 527 - 533, 21.12.2012

Öz

Özet

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.

Keywords: Antibiotic, rational antibiotic use, antibiotic resistance

Kaynakça

  • Ferriman A. BMJ readers choose the ‘‘sanitary revolution’’ as greatest medical advance since 1840. BMJ 2007; 334: 111.
  • Spellberg B, Powers JH, Brass EP, Miller LG, Edwars JE Jr. Trends in antimicrobial drug development: implications for the future. Clin Infect Dis 2004; 38: 1279-86.
  • Molstad S, Erntell M, Hanberger H, Melander E, Norman C, Skoog G, Lundborg CS, Soderstron A, Torell E, Cars O. Sustained reduction of antibiotic use and low bacterial resistance: 10 year follow up the Swedish Strama programme. Lancet Infect Dis 2008; 8: 125-32.
  • Tunger O, Dinc G, Ozbakkaloglu B, atman UC, Umit Algun. Evaluation of rational antibiotic use. Int J Antimicrob Agents 2000; 15: 131-5.
  • Niederman MS. Principles of appropriate antibiotic use. Int J Antimicrob Agents 2005; 26: 170-5.
  • Niederman MS. Appropriate use of antimicrobial agents: challenges and strategies for improvement. Crit Care Med 2003; 31: 608-16.
  • Garau J, Dagan R. Accurate diagnosis and appropriate treatment of acute bacterial rhinosinusitis: minimizing bacterial resistance. Clin Ther 2003; 25: 1936-51.
  • Tunger O, Karakaya Y, Cetin CB, Dinc G, Borand H. Rational antibiotic use. J Infect Dev Ctries 2009; 3: 88-93.
  • Infectious Diseases Society of America. Bad bugs, no drugs: As antibiotic discovery stagnates. A public health crisis brews. July 2004. Available at Retrieved c000005-03-IDSA-vol1.pdf (Accessed on December 3, 2012).
  • Peters NK, Dixon DM, Holland SM, Fauci AS. The research agenda of the National Institute of Allergy and Infectious Diseases for antimicrobial resistance. J Inject Dis 2008; 197: 1087-93.
  • Güven GS, Uzun O. Principles of good use of antibiotics in hospitals. J Hosp Infect 2003; 53: 91-6.
  • Rautakorpi UM, Huikko S, Honkanen P, Klaukka T, Makela M, Palva E, Roine R, Sarkkinen H, Varonen H, huovinen P; MIKSTRA Collaborative Study Group. The Antimicrobial Treatment Strategies (MIKSTRA) program: a 5-year follow- up of infection-specific antibiotic use in primary health care and the effect of implementation of treatment guidelines. Clin Infect Dis 2006; 42: 1221-30.
  • Llor C, Cots JM, Gaspar MJ, Alay M, Rams N. Antibiotic prescribing over the last 16 years: fewer antibiotics but the spectrum is broadening. Eur J Clin Microbiol Infect Dis 2009; 28: 893-7.
  • McCaig LF, Hughes JM. Trends in antimicrobial drug prescribing among office- based physicians in the United States. JAMA 1995; 273: 214-9.
  • File TM Jr, Hadley JA. Rational use of antibiotics to treat respiratory tract infections. Am J Manag Care 2002; 8: 713-27.
  • Çağrı Buke A, Ermertcan S, Hoşgör-Limoncu M, Çiçeklioğlu M, Eren S. Rational antibiotic use and academic staff. Int J Antimicrob Agents 2003; 21: 63- 6.
  • Gonzales R, Steiner JF, Sande MA. Antibiotic prescribing for adults with colds, upper respiratory tract infections, and bronchitis by ambulatory care physicians. JAMA 1997; 278: 901-4.
  • Mcnulty CA. Optimising antibiotic prescribing in primary care. Int J antimicrob Agents 2001; 18: 329-33.
  • Briel M, Christ-Crain M, Young J, Schuetz P, Huber P, Périat P, Bucher HC, Müller B. Procalcitonin-guided antibiotic use versus a standard approach for acute respiratory tract infections in primary care: study protocol for a randomised controlled trial and baseline characteristics of participating general practitioners [ISRCTN73182671]. BMC Fam Pract 2005; 6: 34.
  • Ball P, Baquero F, Cars O, File T, Garau J, Klugman K, Low DE, Rubinstein E, Wise R; Consensus Group on Resistance and Prescribing in Respiratory Tract Infection. Antibiotic therapy of community respiratory tract infections: strategies for optimal outcomes and minimized resistance emergence. J Antimicrob Chemother 2002; 49: 31-40.
  • Larrabee T. Prescribing practices that promote antibiotic resistance: strategies for change. J Pediatr Nurse 2002; 17: 126-32.
  • Gonzales R, Bartlett JG, Besser RE, Cooper RJ, Hickner JM, Hoffman JR, Sande MA. Principles of appropriate antibiotic use for treatment of acute respiratory tract infections in adults: background, specific aims, and methods. Ann Intern Med 2001; 134: 479-86.
  • Kotwani A, Wattal C, Katewa S, Joshi PC, Holloway K. Factors influencing primary care physicians to prescribe antibiotics in Delhi India. Fam Pract 2010; 27: 684-90.
  • Cadieux G, Tamblyn R, Dauphinee D, Libman M. Predictors of inappropriate antibiotic prescribing among primary care physicians. CMAJ 2007; 177: 877-83.
  • Pillai SK, Eliopoulos GM, Moellering RC. Principles of Anti-infective Therapy. In: Mandell GL, Douglas RG, Dolin R, Eds. Principles and Practice of Infectious Diseases, 7th ed. Philadelphia, Penn: Churchill Livinstone 2009; 267-78.
  • Dowell SF, Schwartz B, Phillips WR. Appropriate use of antibiotics for URIs in children: Part II. Cough, pharyngitis and the common cold. The Pediatric URI Consensus Team. Am Fam Physician 1998; 58: 1335-42.
  • Gwaltney JM Jr. Acute community-acquired sinusitis. Clin Infect Dis 1996; 23: 1209-23.
  • Fendrick AM, Saint S, Brook I, Jacobs MR, Pelton S, Sethi S. Diagnosis and treatment of upper respiratory tract infections in the primary care setting. Clin Ther 2001; 23: 1683-706.
  • Kolmos HJ, Little P. Controversies in management: should general practitioners perform diagnostic tests on patients before prescribing antibiotics? Br Med J 1999; 318: 799-802.
  • Grimshaw JM, Russell IT. Effect of clinical guidelines on medical practice: a systematic review of rigorous evaluations. Lancet 1993; 342: 1317-22.
  • Cabana MD, Rand CS, Powe NR, Wu AW, Wilson MH, Abboud PA, Rubin HR. Why don't physicians follow clinical practice guidelines? A framework for improvement. JAMA 1999; 282: 1458-65.
  • Şahin H, Arsu G, Köseli D, Büke C. Evaluation of primary health care physicians’ knowledge on rational antibiotic use. Mikrobiyol Bul 2008; 42: 343- 8.
  • Arnold SR, Straus SE. Interventions to improve antibiotic prescribing practices in ambulatory care. Cochrane Database Syst Rew 2005; 19: Cd003539.
  • Davis DA, Thomson MA, Oxman AD, Haynes RB. Changing physician performance. A systematic review of the effect of continuing medical education strategies. JAMA 1995; 274: 700-5.
  • Buke C, Hosgor-Limoncu M, Ermertcan S, Ciceklioglu M, Tuncel M, Köse T, Eren S. Irrational use of antibiotics among university students. J Infect 2005; 51: 135-9.
  • Macfarlane JT, Holmes WF, Macfarlane RM. Reducing reconsultations for acute lower respiratory tract illness with an information leaflet: a randomized controlled study of patients in primary care. Br J Gen Pract 1997; 47: 719-22.
  • Gwaltney JM Jr, Scheld WM, Sande MA, Sydnor A. The microbial etiology and antimicrobial therapy of adults with acute community-acquired sinusitis: a fifteen-year experience at the University of Virginia and review of other selected studies. J Allergy Clin Immunol 1992; 90: 457-61.
  • Goossens H, Ferech M, Vander Stichele R, Elseviers M; ESAC Project Group. Outpatient antibiotic use in Europe and association with resistance: a cross- national database study. Lancet 2005; 365: 579-87.
  • Rossignoli A, Clavenna A, Bonati M. Antibiotic prescription and prevalence rate in the outpatient paediatric population: analysis of surveys published during 2000-2005. Eur J Clin Pharmacol 2007; 63: 1099-106.
  • Hsu LY, Kwa AL, Lye DC, Chlebicki MP, Tan TY, Ling ML, Wong SY, Goh LG. Reducing antimicrobial resistance through appropriate antibiotic usage in Singapore. Singapore Med J 2008; 49: 749-55.
  • Öztürk İİ, Avci İY, Coşkun Ö, Gül HC, Eyigün CP. Birinci Basamak Sağlık Kuruluşunda Görev Yapan Hekimlerin Sık Görülen Toplum Kaynaklı Enfeksiyonlardaki Antibiyotik Seçimleri ve Bunu Etkileyen Faktörler. Fırat Tıp Dergisi 2008; 13: 255-60.

Ayaktan takip ve tedavi edilen erişkin hastalarda akılcı antibiyotik kullanımı

Yıl 2012, Cilt: 34 Sayı: 4, 527 - 533, 21.12.2012

Öz

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

Kaynakça

  • Ferriman A. BMJ readers choose the ‘‘sanitary revolution’’ as greatest medical advance since 1840. BMJ 2007; 334: 111.
  • Spellberg B, Powers JH, Brass EP, Miller LG, Edwars JE Jr. Trends in antimicrobial drug development: implications for the future. Clin Infect Dis 2004; 38: 1279-86.
  • Molstad S, Erntell M, Hanberger H, Melander E, Norman C, Skoog G, Lundborg CS, Soderstron A, Torell E, Cars O. Sustained reduction of antibiotic use and low bacterial resistance: 10 year follow up the Swedish Strama programme. Lancet Infect Dis 2008; 8: 125-32.
  • Tunger O, Dinc G, Ozbakkaloglu B, atman UC, Umit Algun. Evaluation of rational antibiotic use. Int J Antimicrob Agents 2000; 15: 131-5.
  • Niederman MS. Principles of appropriate antibiotic use. Int J Antimicrob Agents 2005; 26: 170-5.
  • Niederman MS. Appropriate use of antimicrobial agents: challenges and strategies for improvement. Crit Care Med 2003; 31: 608-16.
  • Garau J, Dagan R. Accurate diagnosis and appropriate treatment of acute bacterial rhinosinusitis: minimizing bacterial resistance. Clin Ther 2003; 25: 1936-51.
  • Tunger O, Karakaya Y, Cetin CB, Dinc G, Borand H. Rational antibiotic use. J Infect Dev Ctries 2009; 3: 88-93.
  • Infectious Diseases Society of America. Bad bugs, no drugs: As antibiotic discovery stagnates. A public health crisis brews. July 2004. Available at Retrieved c000005-03-IDSA-vol1.pdf (Accessed on December 3, 2012).
  • Peters NK, Dixon DM, Holland SM, Fauci AS. The research agenda of the National Institute of Allergy and Infectious Diseases for antimicrobial resistance. J Inject Dis 2008; 197: 1087-93.
  • Güven GS, Uzun O. Principles of good use of antibiotics in hospitals. J Hosp Infect 2003; 53: 91-6.
  • Rautakorpi UM, Huikko S, Honkanen P, Klaukka T, Makela M, Palva E, Roine R, Sarkkinen H, Varonen H, huovinen P; MIKSTRA Collaborative Study Group. The Antimicrobial Treatment Strategies (MIKSTRA) program: a 5-year follow- up of infection-specific antibiotic use in primary health care and the effect of implementation of treatment guidelines. Clin Infect Dis 2006; 42: 1221-30.
  • Llor C, Cots JM, Gaspar MJ, Alay M, Rams N. Antibiotic prescribing over the last 16 years: fewer antibiotics but the spectrum is broadening. Eur J Clin Microbiol Infect Dis 2009; 28: 893-7.
  • McCaig LF, Hughes JM. Trends in antimicrobial drug prescribing among office- based physicians in the United States. JAMA 1995; 273: 214-9.
  • File TM Jr, Hadley JA. Rational use of antibiotics to treat respiratory tract infections. Am J Manag Care 2002; 8: 713-27.
  • Çağrı Buke A, Ermertcan S, Hoşgör-Limoncu M, Çiçeklioğlu M, Eren S. Rational antibiotic use and academic staff. Int J Antimicrob Agents 2003; 21: 63- 6.
  • Gonzales R, Steiner JF, Sande MA. Antibiotic prescribing for adults with colds, upper respiratory tract infections, and bronchitis by ambulatory care physicians. JAMA 1997; 278: 901-4.
  • Mcnulty CA. Optimising antibiotic prescribing in primary care. Int J antimicrob Agents 2001; 18: 329-33.
  • Briel M, Christ-Crain M, Young J, Schuetz P, Huber P, Périat P, Bucher HC, Müller B. Procalcitonin-guided antibiotic use versus a standard approach for acute respiratory tract infections in primary care: study protocol for a randomised controlled trial and baseline characteristics of participating general practitioners [ISRCTN73182671]. BMC Fam Pract 2005; 6: 34.
  • Ball P, Baquero F, Cars O, File T, Garau J, Klugman K, Low DE, Rubinstein E, Wise R; Consensus Group on Resistance and Prescribing in Respiratory Tract Infection. Antibiotic therapy of community respiratory tract infections: strategies for optimal outcomes and minimized resistance emergence. J Antimicrob Chemother 2002; 49: 31-40.
  • Larrabee T. Prescribing practices that promote antibiotic resistance: strategies for change. J Pediatr Nurse 2002; 17: 126-32.
  • Gonzales R, Bartlett JG, Besser RE, Cooper RJ, Hickner JM, Hoffman JR, Sande MA. Principles of appropriate antibiotic use for treatment of acute respiratory tract infections in adults: background, specific aims, and methods. Ann Intern Med 2001; 134: 479-86.
  • Kotwani A, Wattal C, Katewa S, Joshi PC, Holloway K. Factors influencing primary care physicians to prescribe antibiotics in Delhi India. Fam Pract 2010; 27: 684-90.
  • Cadieux G, Tamblyn R, Dauphinee D, Libman M. Predictors of inappropriate antibiotic prescribing among primary care physicians. CMAJ 2007; 177: 877-83.
  • Pillai SK, Eliopoulos GM, Moellering RC. Principles of Anti-infective Therapy. In: Mandell GL, Douglas RG, Dolin R, Eds. Principles and Practice of Infectious Diseases, 7th ed. Philadelphia, Penn: Churchill Livinstone 2009; 267-78.
  • Dowell SF, Schwartz B, Phillips WR. Appropriate use of antibiotics for URIs in children: Part II. Cough, pharyngitis and the common cold. The Pediatric URI Consensus Team. Am Fam Physician 1998; 58: 1335-42.
  • Gwaltney JM Jr. Acute community-acquired sinusitis. Clin Infect Dis 1996; 23: 1209-23.
  • Fendrick AM, Saint S, Brook I, Jacobs MR, Pelton S, Sethi S. Diagnosis and treatment of upper respiratory tract infections in the primary care setting. Clin Ther 2001; 23: 1683-706.
  • Kolmos HJ, Little P. Controversies in management: should general practitioners perform diagnostic tests on patients before prescribing antibiotics? Br Med J 1999; 318: 799-802.
  • Grimshaw JM, Russell IT. Effect of clinical guidelines on medical practice: a systematic review of rigorous evaluations. Lancet 1993; 342: 1317-22.
  • Cabana MD, Rand CS, Powe NR, Wu AW, Wilson MH, Abboud PA, Rubin HR. Why don't physicians follow clinical practice guidelines? A framework for improvement. JAMA 1999; 282: 1458-65.
  • Şahin H, Arsu G, Köseli D, Büke C. Evaluation of primary health care physicians’ knowledge on rational antibiotic use. Mikrobiyol Bul 2008; 42: 343- 8.
  • Arnold SR, Straus SE. Interventions to improve antibiotic prescribing practices in ambulatory care. Cochrane Database Syst Rew 2005; 19: Cd003539.
  • Davis DA, Thomson MA, Oxman AD, Haynes RB. Changing physician performance. A systematic review of the effect of continuing medical education strategies. JAMA 1995; 274: 700-5.
  • Buke C, Hosgor-Limoncu M, Ermertcan S, Ciceklioglu M, Tuncel M, Köse T, Eren S. Irrational use of antibiotics among university students. J Infect 2005; 51: 135-9.
  • Macfarlane JT, Holmes WF, Macfarlane RM. Reducing reconsultations for acute lower respiratory tract illness with an information leaflet: a randomized controlled study of patients in primary care. Br J Gen Pract 1997; 47: 719-22.
  • Gwaltney JM Jr, Scheld WM, Sande MA, Sydnor A. The microbial etiology and antimicrobial therapy of adults with acute community-acquired sinusitis: a fifteen-year experience at the University of Virginia and review of other selected studies. J Allergy Clin Immunol 1992; 90: 457-61.
  • Goossens H, Ferech M, Vander Stichele R, Elseviers M; ESAC Project Group. Outpatient antibiotic use in Europe and association with resistance: a cross- national database study. Lancet 2005; 365: 579-87.
  • Rossignoli A, Clavenna A, Bonati M. Antibiotic prescription and prevalence rate in the outpatient paediatric population: analysis of surveys published during 2000-2005. Eur J Clin Pharmacol 2007; 63: 1099-106.
  • Hsu LY, Kwa AL, Lye DC, Chlebicki MP, Tan TY, Ling ML, Wong SY, Goh LG. Reducing antimicrobial resistance through appropriate antibiotic usage in Singapore. Singapore Med J 2008; 49: 749-55.
  • Öztürk İİ, Avci İY, Coşkun Ö, Gül HC, Eyigün CP. Birinci Basamak Sağlık Kuruluşunda Görev Yapan Hekimlerin Sık Görülen Toplum Kaynaklı Enfeksiyonlardaki Antibiyotik Seçimleri ve Bunu Etkileyen Faktörler. Fırat Tıp Dergisi 2008; 13: 255-60.
Toplam 41 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Bölüm Derlemeler
Yazarlar

Mustafa Gözel

Yayımlanma Tarihi 21 Aralık 2012
Yayımlandığı Sayı Yıl 2012Cilt: 34 Sayı: 4

Kaynak Göster

AMA Gözel M. Ayaktan takip ve tedavi edilen erişkin hastalarda akılcı antibiyotik kullanımı. CMJ. Aralık 2012;34(4):527-533.