Publication: Acil servislerde çalışan hekimlerin idrar yolu enfeksiyonlarının tedavisinde kinolon kullanımı alışkalıklarının değerlendirilmesi
Abstract
Giriş: idrar yolu enfeksiyonu (İYE) acil servislerde sık karşılaşılan enfeksiyon hastalıklarından biridir ve tedavisinde kinolonlar daha fazla sıklıkta kullanılmaktadır. Bu çalışmada İYE endikasyonu üzerinden, acil servislerde çalışan hekimlerin kinolon kullanımı alışkanlıklarının değerlendirilmesi amaçlandı. Gereç ve Yöntem: Tanımlayıcı tipteki bu araştırmada, Türkiye'nin değişik illerindeki 18 farklı hastanenin acil servislerinde çalışan, toplam 56 hekime (43 erkek (%76.8), 13 kadın (%23.2); ort. yaş 31.2±4.5), İYE tedavisinde "kinolon kullanımı" alışkanlıklarını saptamaya yönelik anket uygulandı. Bulgular: Ankete katılan hekimlerin %87.3'ü son bir yıl içerisinde kinolon grubu antibiyotikleri en sık tercih ettikleri endikasyonun İYE olduğunu, %33.9'u hastalarına herhangi bir antibiyotik tedavisi başlamadan önce kültür antibiyogram tetkiki yaptırdığını, %37.5'i ise, kinolon grubu antibiyotik verirken bu tetkiki yaptırdığını ifade etti. Katılımcıların ilaç seçim kriterlerinden en fazla "etkililik" kriterini, en az ise "maliyet" kriterini dikkate aldıkları saptandı. Antibiyotik seçerken hastalarının alım gücünü dikkate aldığını belirten hekimler, son bir yıl içinde hastalarından ortalama 37.5±22'sine alım gücü yetersizliği nedeniyle, başlangıçta düşündüğü antibiyotik yerine daha ucuz olanını yazmak zorunda kaldığını bildirdi. Uzman hekimlerle, uzman olmayanların ankete verdikleri cevapların genel olarak birbirlerine benzediği görüldü. Sonuç: Acil servislerde çalışan hekimlerin kinolonları daha çok İYE tedavisinde ve ampirik olarak tercih etme eğiliminde oldukları, her ne kadar ilaç seçim kriterlerinden maliyeti daha az dikkate aldıklarını belirtseler de, son bir yıllık deneyimlerine göre antibiyotik tedavisi başlarken hastalarının önemli bir bölümünde tedavi maliyetinin antibiyotik seçimlerini etkilediği ortaya konmuş oldu.
Objectives: Urinary tract infection (UTI) is a commonly encountered infectious disease in the emergency department, and quinolones have gradually become more frequently used in the treatment of UTI. The aim of this study was to evaluate the "quinolone utilization" habits of emergency department physicians for the treat­ment of UTI. Materials and Methods: In this descriptive study, a total of 56 physicians (43 males (76.8%), 13 females (23.2%); mean age 31.2+4.5) working in emergency departments of 18 distinct hospitals in various cities, were surveyed regarding their use of quinolones for UTI. Results: Eighty seven percent of the physicians stated that UTI was the most common diagnosis that they pre­ferred quinolones. 33.9% stated that they obtained a urine culture prior to any antibiotic treatment, whereas 37.5% stated that they only obtained a urine culture prior to administration of quinolones. Most participants stated that they took into consideration the "efficacy" for the choice of treatment. The "cost" of treatment was considered the least. Physicians, who take into consideration the financial condition of the patients while pre­scribing a drug, stated that in the past year, they prescribed a cheaper drug to approximately 37.5±22 patients, because patients could not afford the originally chosen drug. Generally, there was no difference between spe­cialists and practitioners regarding their answers to the questions. Conclusion: This study shows that physicians working in emergency departments tend to prefer quinolones mostly for treatment of UTI and as an empirical treatment. It also revealed that cost of treatment affected physi­cians'choice of the drug in a majority of cases.
Objectives: Urinary tract infection (UTI) is a commonly encountered infectious disease in the emergency department, and quinolones have gradually become more frequently used in the treatment of UTI. The aim of this study was to evaluate the "quinolone utilization" habits of emergency department physicians for the treat­ment of UTI. Materials and Methods: In this descriptive study, a total of 56 physicians (43 males (76.8%), 13 females (23.2%); mean age 31.2+4.5) working in emergency departments of 18 distinct hospitals in various cities, were surveyed regarding their use of quinolones for UTI. Results: Eighty seven percent of the physicians stated that UTI was the most common diagnosis that they pre­ferred quinolones. 33.9% stated that they obtained a urine culture prior to any antibiotic treatment, whereas 37.5% stated that they only obtained a urine culture prior to administration of quinolones. Most participants stated that they took into consideration the "efficacy" for the choice of treatment. The "cost" of treatment was considered the least. Physicians, who take into consideration the financial condition of the patients while pre­scribing a drug, stated that in the past year, they prescribed a cheaper drug to approximately 37.5±22 patients, because patients could not afford the originally chosen drug. Generally, there was no difference between spe­cialists and practitioners regarding their answers to the questions. Conclusion: This study shows that physicians working in emergency departments tend to prefer quinolones mostly for treatment of UTI and as an empirical treatment. It also revealed that cost of treatment affected physi­cians'choice of the drug in a majority of cases.