Uriner sistem enfeksiyonlarında uygun olmayan ampirik antibiyoterapi seçiminin klinik sonuçları


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Çakıcı M. Ç. , Çiçek M., Çaşkurlu H. , Kazan Ö., Yıldırım A.

28. Ulusal Üroloji Kongresi, Antalya, Türkiye, 10 - 13 Ekim 2019, ss.8-9

  • Basıldığı Şehir: Antalya
  • Basıldığı Ülke: Türkiye
  • Sayfa Sayıları: ss.8-9

Özet

OBJECTIVE: To compare duration of hospitalization and urine culture sterilization between patients who received inpatient antibiotic treatment in the urology clinic and those who received

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inadequate empirical antibiotherapy.
MATERIAL-METHODS: We retrospectively rewiewed patients treated with antibiotics in our clinic between January 2017-January 2019. Patient carecteristics, gender, age, comorbidities, liver disease, history of norological deficit, lenght of hospital stay, history of urinary tract infections (UTI), surgical operation before antibiotherapy, duration of empirical antibiotherapy, revision of treatment and urine culture results were recorded.
RESULTS: 106 patients who were hospitalized with urinary tract infection and whose data were recorded in our clinic were included in the study. 27 patients who were administered empirical antimicrobial treatment with inadequate antibiotics, required antimicrobial treatment revision (Group 1). Empiric antimicrobial therapy was administered to 79 patients with adequate antibiotics (Group 2). These two groups statistically compared. Avarege hospital stay lenght was longer in group 1 compared group 2 (13,5±4,0 vs 9,9±4,0, respectively, p<0,001). Liver disease history (%14,8 vs %3,7) more frequent in group 1 than group 2 (%14,8-%3,8, respectively, p=0,048). Gram + agents more frequent in group 1 (p=0,005). According to multivariate regression analysis, we found that the most important factor in inadequate antibiotherapy was the presence of gram (+) bacteria (odds ratio=0.271, p=0.002).
CONCLUSION: Inadequate empirical antibiotic administration is associated with prolonged hospitalization and prolonged recovery. Specifically, gram (+) bacteria significantly affect selection failure for empirical antibiotherapy. The choice of inappropriate antibiotherapy increases the cost by increasing the number of antibiotics used and delaying the return to working life. Therefore, we should be more careful in choosing empirical treatment.