Febril nötropenili çocuklarda risk temelli tedavi
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Dosyalar
Tarih
2015-02-06
Kurum Yazarları
Köse, Doğan
Ünal, Ekrem
Küçükkeleş, Hediye
Köksal, Yavuz
Süreli Yayın başlığı
Süreli Yayın ISSN
Cilt Başlığı
Yayınevi
Uludağ Üniversitesi
Özet
Gelişen ilaç direnci antibiyotiklerin akılcı kullanımını gerektirmektedir. Bu yazıda; febril nötropenide monoterapi ve oral tedavinin etkinliğinin değerlendirilmesi amaçlanmıştır. Bu çalışmada, 44 hastada görülen, 64 febril nötropeni atağı retrospektif olarak değerlendirildi. Düşük risk grubunda, bir kola; imipenem, bir kola ise üç gün imipenem+beş gün oral sefiksim verilirken, yüksek risk grubunda, bir kola; seftazidim+amikasin, diğer kola da sadece imipenem verilmişti. Çalışmaya alınan hastalardan kaybedilen olmamıştı. Tüm grupta modifikasyonsuz ampirik tedavinin başarısı %78 idi. Aynı başarı düşük risk imipenem kolunda %53,8, üç gün imipenem+beş gün sefiksim kolunda %92,3 iken (p=0,037), yüksek risk seftazidim+amikasin kolunda %81,3 ve imipenem kolunda ise %81,8 idi (p=0,641). Hasta sayımız kısıtlı olmakla birlikte, ampirik tedavide, düşük riskli hastalarda oral tedavi daha başarılı olurken, yüksek riskli hastalarda her iki kolun başarılarının aynı olması nedeniyle monoterapi daha üstün olarak kabul edilmiştir.
Developing drug resistance requires the rational use of antibiotics. In this study; it is aimed to assess the affectivity of the oral treatment and monotherapy in febrile neutropenia. In this study, 64 febrile neutropenia attacks that have observed in 44 patients were evaluated retrospectively. In the low risk group, when a starch has provided; imipenem, a starch has been providing three days imipenem+five days oral cefixime, in the high risk group; a starch was provided as cefixime+amicasin, other starch was provided as imipenem. None of the patients who were involved in the study lost their lives. The empiric treatment success without any modification in entire group was 78%. The same success was 53,8% in low risk imipenem brachion, the same success was 92,3% in three days imipenem+five days cefixime brachion (p=0,037), it was 81,3% in high risk cefixime+amicasin brachion and in the imienem brachion, it was 81,8% (p=0,641). Due to the fact that our number of patient is restricted, in the empiric treatment, the oral treatment could be more effective in the oral treatment however, in high risky patients, monotherapy is accepted as betterness because each brachion has same success.
Developing drug resistance requires the rational use of antibiotics. In this study; it is aimed to assess the affectivity of the oral treatment and monotherapy in febrile neutropenia. In this study, 64 febrile neutropenia attacks that have observed in 44 patients were evaluated retrospectively. In the low risk group, when a starch has provided; imipenem, a starch has been providing three days imipenem+five days oral cefixime, in the high risk group; a starch was provided as cefixime+amicasin, other starch was provided as imipenem. None of the patients who were involved in the study lost their lives. The empiric treatment success without any modification in entire group was 78%. The same success was 53,8% in low risk imipenem brachion, the same success was 92,3% in three days imipenem+five days cefixime brachion (p=0,037), it was 81,3% in high risk cefixime+amicasin brachion and in the imienem brachion, it was 81,8% (p=0,641). Due to the fact that our number of patient is restricted, in the empiric treatment, the oral treatment could be more effective in the oral treatment however, in high risky patients, monotherapy is accepted as betterness because each brachion has same success.
Açıklama
Anahtar kelimeler
Antibiyotik, Antibiotic, Çocuk, Febril nötropeni, Risk temelli tedavi, Child, Febrile neutropenia, Risk based treatment
Alıntı
Köse, D. vd. (2014). "Febril nötropenili çocuklarda risk temelli tedavi" Uludağ Üniversitesi Tıp Fakültesi Dergisi, 40(3),143-147.