Person: ERTÜRK ŞENGEL, BUKET
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ERTÜRK ŞENGEL
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BUKET
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Publication Metadata only Switch to oral antibiotics in Gram-negative bacteraemia: a randomized, open-label, clinical trial(2023-01-01) ERTÜRK ŞENGEL, BUKET; Omrani A. S., Abujarir S. H., Ben Abid F., Shaar S. H., Yilmaz M., Shaukat A., Alsamawi M. S., Elgara M. S., Alghazzawi M. I., Shunnar K. M., et al.Objectives: To evaluate the safety and efficacy of switching from intravenous (IV) to oral antimicrobial therapy in patients with Enterobacterales bacteraemia, after completion of 3–5 days of microbiologically active IV therapy. Methods: A multicentre, open-label, randomized trial of adults with monomicrobial Enterobacterales bacteraemia caused by a strain susceptible to ≥1 oral beta-lactam, quinolone, or trimethoprim/sulfamethoxazole. Inclusion criteria included completion of 3–5 days of microbiologically active IV therapy, being afebrile and haemodynamically stable for ≥48 hours, and absence of an uncontrolled source of infection. Pregnancy, endocarditis, and neurological infections were exclusion criteria. Randomization, stratified by urinary source of bacteraemia, was to continue IV (IV Group) or to switch to oral therapy (Oral Group). Agents and duration of therapy were determined by the treating physicians. The primary endpoint was treatment failure, defined as death, need for additional antimicrobial therapy, microbiological relapse, or infection-related re-admission within 90 days. Non-inferiority threshold was set at 10% in the 95% CI for the difference in the proportion with treatment failure between the Oral and IV Groups in the modified intention-to-treat population. The protocol was registered at ClinicalTrials.gov (NCT04146922). Results: In the modified intention-to-treat population, treatment failure occurred in 21 of 82 (25.6%) in the IV Group, and 18 of 83 (21.7%) in the Oral Group (risk difference –3.7%, 95% CI –16.6% to 9.2%). The proportions of subjects with any adverse events (AE), serious AE, or AE leading to treatment discontinuation were comparable. Discussion: In patients with Enterobacterales bacteraemia, oral switch, after initial IV antimicrobial therapy, clinical stability, and source control, is non-inferior to continuing IV therapy.Publication Metadata only Clinical Pharmacist-Led Medication Review in Hospitalized Confirmed or Probable Patients with COVID-19 During the First Wave of COVID-19 Pandemic(2024-01-01) ÜNDER, DUYGU; ENVER, CÜNEYD; DEMİRCİ, MUHAMMED YASİR; AYHAN, YUNUS EMRE; ÖZGAN, BETÜL; İLERLER, ENES EMİR; OKUYAN, BETÜL; ERTÜRK ŞENGEL, BUKET; KOCAKAYA, DERYA; SİLİ, ULUHAN; TİGEN, ELİF; KARAKURT, SAİT; KORTEN, VOLKAN; SANCAR, MESUT; ÜNDER D., ENVER C., DEMİRCİ M. Y., AYHAN Y. E., ÖZGAN B., İLERLER E. E., OKUYAN B., ERTÜRK ŞENGEL B., KOCAKAYA D., SİLİ U., et al.Objectives: Drug-related problems (DRPs) result in serious problems among hospitalized patients, high rates of morbidity and mortality, and increased healthcare costs. This study aimed to identify DRPs by clinical pharmacist-led medication review in hospitalized probable patients with coronavirus disease-2019 (COVID-19) during the first wave of the COVID-19 pandemic. Materials and Methods: This retrospective cross-sectional study was conducted at the COVID-19 inpatient services of a tertiary university hospital in Türkiye for 3 months (between March 2020 and June 2020) and included hospitalized confirmed or probable COVID-19 patients. The World Health Organization and Turkish Ministry of Health Guidelines case definitions were used to define confirmed and probable COVID-19 patients. Six clinical pharmacy residents provided medication review services during their education and training. DRPs were classified based on the Pharmaceutical Care Network Europe V9.00. The physician’s acceptance rate of clinical pharmacists’ recommendations was assessed. Results: Among 202 hospitalized patients with probable or confirmed COVID-19, 132 (65.3%) had at least one drug-related problem. Two hundred and sixty-four DRPs were identified. Drug selection (85.6%) and dose selection (9.2%) were the most common causes of these problems. Among the 80 clinical pharmacist interventions, 48.8% were accepted by the physicians. Conclusion: Clinical pharmacists identified a significant number of DRPs during the COVID-19 pandemic, particularly those related to drug interactions and drug safety, such as adverse drug reactions. This study highlights the importance of detecting and responding to DRPs in the COVID-19 pandemic.Publication Metadata only Prevalence of polypharmacy and potential drug-drug interactions associated with risk factors in the era of hiv integrase inhibitors: A prospective clinical study(2023-02-01) YAĞÇI ÇAĞLAYIK, DİLEK; TİGEN, ELİF; SİLİ, ULUHAN; ERTÜRK ŞENGEL, BUKET; KORTEN, VOLKAN; Altunal L. N., YAĞÇI ÇAĞLAYIK D., Ozel A. S., TİGEN E., SİLİ U., ERTÜRK ŞENGEL B., Aydin M., KORTEN V.People living with human immunodeficiency virus (PLWH), with the availability of modern antiretroviral drugs, have multiple comorbidities, which increase the risk of polypharmacy and potential drug-drug interactions (PDDIs). This is a particularly important issue for the aging population of PLWH. This study aims to review the prevalence and risk factors for PDDIs and polypharmacy in the era of HIV integrase inhibitors. A cross-sectional, two-center, prospective observational study was conducted on Turkish outpatients between October 2021 and April 2022. Polypharmacy was defined as the use of >= 5 non-HIV medications, excluding over-the-counter (OTC) drugs, and PDDIs were classified using the University of Liverpool HIV Drug Interaction Database (harmful/red flagged and potentially clinically relevant/amber flagged). The median age of the 502 PLWH included in the study was 42 +/- 12.4 years and 86.1% were males. Most individuals (96.4%) were given integrase-based regimens (unboosted 68.7% and boosted 27.7%). In total, 30.7% of individuals were taking at least one OTC drug. The prevalence of polypharmacy was 6.8% (9.2% when OTC drugs were included). During the study period, the prevalence of PDDIs was 1.2% for red flag PDDIs and 16% for amber flag PDDIs. CD4(+) T cell count >500 cells/mm(3), number of comorbidities >= 3, comedication with drugs affecting blood and blood-forming organs, cardiovascular drugs, and vitamin/mineral supplements were associated with red flag or amber flag PDDIs. Drug interaction prevention is still important in HIV care. Individuals with multiple comorbidities should be closely monitored for non-HIV medications to prevent PDDIs.