Araştırma ve uygulama hastanesine devredilen bir hastanenin yeni doğan ve çocuk yoğun bakım ünitelerindeki antibiyotik sürveyansı ve maliyet değişimi
Küçük Resim Yok
Tarih
2015
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
AMAÇ: Bu çalışmada, Tekirdağ ili ikinci basamakta bulunan yeni doğan ve çocuk yoğun bakım ünitelerinin, üçüncü basamak ile ortak kullanıma devredilme protokolü sonrasındaki antibiyotik kullanım ve maliyet değişimlerini saptamak, akılcı antibiyotik kullanımı konusunda farkındalık yaratmak amaçlandı. YÖNTEM: Araştırma, 01 Ağustos 2013-31 Ocak 2014 tarihleri arasında 392 hastada gerçekleştirildi. Protokol gereği tıp fakültesi kullanımına devredilen yeni doğan ve çocuk yoğun bakım ünitelerinde, protokol öncesi ve sonrasındaki doksanar günlük sürede kullanılan antibiyotik sürveyansı ve maliyetleri karşılaştırıldı. Antibiyotikler, Akılcı İlaç Kullanım Komisyonu, Enfeksiyon Kontrol Komitesi ve Antibiyotik Kontrol Komiteleri tedavi protokollerine göre değerlendirildi. Antibiyotikler, malzeme kaynakları yönetim sisteminden, maliyetler ise Maliye Bakanlığı ve Sağlık Bakanlığından elde edildi. Verilere demografik bilgiler, ünitelere kabul nedeni, antibiyotik dozları ve enfeksiyon etkenleri eklendi. İstatistiksel analizler için SPSS paket programı kullanıldı. Tanımlayıcı analizler yapıldı. Karşılaştırılmalarda Mann Whitney U ve ki-kare testleri kullanıldı. Veriler %95 güven aralığında değerlendirildi. BULGULAR: İlk ve ikinci doksan günde, çocuk yoğun bakım ünitesinde sırasıyla 143 hasta 3,18±1,13 gün ve 105 hasta 2,69±4,14 gün; yeni doğan yoğun bakım ünitesinde sırasıyla 79 hasta 3,08±4,42 gün ve 65 hasta 3,63±6,25 gün yattığı raporlandı. İlk ve ikinci dönemde, çocuk yoğun bakım ünitesinde kullanılan antibiyotiklerin toplam maliyeti sırasıyla 341,81±744,49 (ortanca:14,91) ve 585,35±796,62 (ortanca:256,44) (p=0.02); yeni doğan yoğun bakım ünitesinde sırasıyla 137,92±178,78 (ortanca:14.59) ve 247,40±370,13 (ortanca:19,23) (p=0.76) bulundu. SONUÇ: İkinci dönemde çocuk yoğun bakım ünitesinde yatış süresinin kısaldığı, antibiyotik maliyetinin ise yükseldiği dikkat çekici idi. Yeni doğan yoğun bakım ünitesinde ise yatış süresinin uzamasına ve antibiyotik maliyetinin yükselmiş gibi görünmesine rağmen anlamlı fark bulunamadı. İki dönem arasındaki maliyet farkı, yeni doğan ve çocuk yoğun bakım ünitelerinde antibiyotik tedavi protokollerinin çocuk enfeksiyon hastalıkları uzmanı ile birlikte oluşturulması gerekliliğini gösterdi.
AİM: The objective of this study is to show the alterations in frequency and cost of antibiotic use in neonatal and pediatric intensive care units of a state hospital after it started to service as an education and research hospital. We also aimed to raise an awareness related to rational antibiotic use. METHODS: The surveillance of antibiotic use and comparison of costs were evaluated in 392 patients in between August 2013-January 2014. The rate and cost of antibiotic use during last 90 days before the protocol of state hospital to research and education hospital and the first 90 days after protocol were evaluated. Antibiotics were assessed according to the treatment protocols of the Committee of Rational Drug Use, Infection Control Committee and Antibiotic Control Committee. Antibiotics were provided from administrative system and the data related to costs were obtained from Ministry of Health and Ministry of Finance. The demographic data and the data related to indication for admission to intensive care units, antibiotic dosages and pathogens causing infections were also obtained. For statistical analysis, SPSS program was used and descriptive analysis were made. In comparison of the groups, Mann Whitney U and chi-square tests were used. The data were evaluated within a 95% confidence interval. RESULTS: In first and second period, 143 patients were hospitalized for 3.18±1.13 days and 105 patients were hospitalized for 2.69±4.14 days in pediatric intensive care unit(PICU); 79 patients were hospitalized for 17.29±3.61 days and 65 patients stayed for 21.29±3.29 days in neonatal intensive care unit(NICU), respectively. In the first and second period, cost of antibiotics in PICU was found 341.81±744.49 (med:14.91) and 585.35±796.62 (med:256.44) (p=0.02) Turkish Liras (TL); in NICU 137.92±178.78 (med:14.59) and 247.40±370.13(med:19.23) (p=0.76) TL respectively. CONCLUSİON: In the second period, in PICU, duration of hospitalization was found to decrease and costs of antibiotics were higher. In NICU, the duration of hospitalization was longer and although statistically insignificant, costs of antibiotics were slightly higher. Differences between the two periods in term of cost showed that, PICUs and ICUs should revisit their antibiotic preferences from the viewpoint of a pediatric infectious disease physician.
AİM: The objective of this study is to show the alterations in frequency and cost of antibiotic use in neonatal and pediatric intensive care units of a state hospital after it started to service as an education and research hospital. We also aimed to raise an awareness related to rational antibiotic use. METHODS: The surveillance of antibiotic use and comparison of costs were evaluated in 392 patients in between August 2013-January 2014. The rate and cost of antibiotic use during last 90 days before the protocol of state hospital to research and education hospital and the first 90 days after protocol were evaluated. Antibiotics were assessed according to the treatment protocols of the Committee of Rational Drug Use, Infection Control Committee and Antibiotic Control Committee. Antibiotics were provided from administrative system and the data related to costs were obtained from Ministry of Health and Ministry of Finance. The demographic data and the data related to indication for admission to intensive care units, antibiotic dosages and pathogens causing infections were also obtained. For statistical analysis, SPSS program was used and descriptive analysis were made. In comparison of the groups, Mann Whitney U and chi-square tests were used. The data were evaluated within a 95% confidence interval. RESULTS: In first and second period, 143 patients were hospitalized for 3.18±1.13 days and 105 patients were hospitalized for 2.69±4.14 days in pediatric intensive care unit(PICU); 79 patients were hospitalized for 17.29±3.61 days and 65 patients stayed for 21.29±3.29 days in neonatal intensive care unit(NICU), respectively. In the first and second period, cost of antibiotics in PICU was found 341.81±744.49 (med:14.91) and 585.35±796.62 (med:256.44) (p=0.02) Turkish Liras (TL); in NICU 137.92±178.78 (med:14.59) and 247.40±370.13(med:19.23) (p=0.76) TL respectively. CONCLUSİON: In the second period, in PICU, duration of hospitalization was found to decrease and costs of antibiotics were higher. In NICU, the duration of hospitalization was longer and although statistically insignificant, costs of antibiotics were slightly higher. Differences between the two periods in term of cost showed that, PICUs and ICUs should revisit their antibiotic preferences from the viewpoint of a pediatric infectious disease physician.
Açıklama
Anahtar Kelimeler
Yoğun Bakım, Tıp
Kaynak
TSK Koruyucu Hekimlik Bülteni
WoS Q Değeri
Scopus Q Değeri
Cilt
14
Sayı
2
