Research Article
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Can inappropriate use of antibiotic prolong the length of hospital stay in acute gastroenteritis?

Year 2018, Volume: 15 Issue: 2, 85 - 91, 14.08.2018

Abstract

Background: The aim of this study was to clinically evaluate the patients admitted to our hospital and treated with the diagnosis of AGE (acute gastroenteritis), and to investigate the treatment techniques administered to these patients before admitting to our hospital.

Material and Methods: The clinical records of the patients were retrospectively reviewed.

Results: 352 cases diagnosed with AGE were included in the study. 61.1% of the patients were male and 38.9% were female. The mean age of the patients was 14.8 ± 19.3 months. When the 244 patients with the diagnosis of AGE and without any comorbidity were divided into two groups and examined according to their use of oral antibiotics before admitting to our clinic, the length of hospital stay was significantly shorter in the group not used oral antibiotic than in the group used oral antibiotic (p<0.001). The mean healthcare costs were lower in the group not used oral antibiotic than in the group used oral antibiotic.

Conclusion: In cases with AGE, the mean length of hospital stay is not affected by gender, causative pathogen and presence of dehydration. It has been thought that the inappropriate use of antibiotic in the AGE treatment may increase the healthcare costs by prolonging the mean length of hospital stay.

References

  • Degiuseppe JI. Tendencia de los egresos hospitalarios por enfermedades infecciosas intestinales en niños en Argentina, 2005-2013. Arch Argent Pediatr. 2017;115(4):350-6.
  • Freedman SB, Ali S, Oleszczuk M, Gouin S, Hartling L. Treatment of acute gastroenteritis in children: an overview of systematic reviews of interventions commonly used in developed countries. Evid Based Child Health. 2013;8(4):1123-37.
  • Celik AY, Emiroglu M, Kurtoglu MG, Inci A, Odabas D. Akut Gastroenteritli 0-5 Yaş Arası Çocuklarda Viral Etkenlerin Sıklığının Araştırılması. Türkiye Çocuk Hastalıkları Dergisi, 2016;2:101-6.
  • Liu L, Oza S, Hogan D, Chu Y, Perin J, Zhu J, et al. Global, regional, and national causes of under-5 mortality in 2000- 15: an updated systematic analysis with implications for the sustainable development goals. Lancet. 2016;388(10063):3027–35.
  • Liu L, Johnson H, Cousens S. Global, regional, and national causes of child mortality in 2000-2010: an updated systematic analysis. Lancet. 2012;379(9832):2151-61.
  • Kızılırmak A, Çalışkan E, Temizkan RC. Akut Gastroenteritli Çocuklarda Rotavirus ve Adenovirus SıklığI. Konuralp Tıp Dergisi, 2017;9(2):35-9.
  • Lu L, Zhong H, Su L, Cao L, Xu M, Dong N, et al. Detection and Molecular Characterization of Human Adenovirus Infections among Hospitalized Children with Acute Diarrhea in Shanghai, China, 2006–2011. Can J Infect Dis Med Microbiol. 2017;2017:9304830
  • Urbiztondo I, Bjerrum L, Caballero L, Suarez MA, Olinisky M, Córdoba G. Decreasing Inappropriate Use of Antibiotics in Primary Care in Four Countries in South America-Cluster Randomized Controlled Trial. Antibiotics (Basel). 2017;6(4):38.
  • Devasia RA, Varma JK, Whichard J, Gettner S, Cronquist AB, Hurd S, et al. Antimicrobial use and outcomes in patients with multidrug-resistant and pansusceptible Salmonella newport infections, 2002–2003. Microb Drug Resist. 2005;11(4):371–7.
  • Schnadower D, Tarr P, Gorelick MH, O’Connell K, Roskind CG, Powell EC, et al. Validation of the Modified Vesikari Score in Children with Gastroenteritis in 5 U.S. Emergency Departments. J Pediatr Gastroenterol Nutr. 2013;57(4):514–9.
  • A Falszewska, P Dziechciarz, Szajewska H. The diagnostic accuracy of Clinical Dehydration Scale in identifying dehydration in children with acute gastroenteritis: a systematic review. Eur J Pediatr 2017;176:1021–26.
  • Guarino A, Ashkenazi S, Gendrel D, Lo Vecchio A, Shamir R, Szajewska H; European Society for Pediatric Gastroenterology, Hepatology, and Nutrition; European Society for Pediatric Infectious Diseases. European Society for Pediatric Gastroenterology, Hepatology, and Nutrition/European Society for Pediatric Infectious Diseases evidence-based guidelines for the management of acute gastroenteritis in children in Europe: update 2014. J Pediatr Gastroenterol Nutr. 2014;59(1):132-52.
  • World Health Organization (WHO). Health topics: diarrhea Available at: http://www.who.int/topics/diarrhoea/en/, Date of access: February 26, 2018
  • Alcalá AC, Pérez K, Blanco R, González R, Ludert JE, Liprandi F, et al. Molecular detection of human enteric viruses circulating among children with acute gastroenteritis in Valencia, Venezuela, before rotavirus vaccine implementation. Gut Pathog. 2018;10:6.
  • Bulut Y, Yenişehirli G, Durmaz R. Molecular Epidemiology of Rotavirus Strains in Under Five Children. Indian J Pediatr. 2018;85(5):364-8.
  • Gubruz F, Tezer H, Saylı TR. Etiologic factors and clinical findings oaf patients hospitalized children for acute gastroenteritis: Epidemiologic study. Turkish J Pediatr Dis. 2010; 4(4): 211-8.
  • Oikarinen S, Tauriainen S, Viskari H, Simell O, Knip M, Virtanen S, et al. PCR inhibition in stool samples in relation to age of infants. J Clin Virol 2009;211-4.
  • Selek MB, Bektore B, Karagoz E, Baylan O, Ozyurt M. Distribution of Parasites Detected in Stool Samples of Patients Admitted to Our Parasitology Laboratory during a Three-Year Period between 2012 and 2014. Turkiye Parazitol Derg. 2016;40:137-40.
  • Ahmed T, Khanum H, Uddin MS, Barua P, Arju T, Kabir M, et al. Entamoeba histolytica, giardia lamblia and cryptosporidium spp. infection in children in an urban slum area of Bangladesh. Biores Commun. 2016;2(1):175-81.
  • Ahmad A, Khan MU, Malik S, Mohanta GP, Parimalakrishnan S, Patel I, et al. Prescription patterns and appropriateness of antibiotics in the management of cough/cold and diarrhea in a rural tertiary care teaching hospital. J Pharm Bioallied Sci 2016;8(4):335- 40.
  • Bruzzese E, Giannattasio A, Guarino A. Antibiotic treatment of acute gastroenteritis in children. F1000Research. 2018;7:193-203.
  • Nitzan O, Elias M, Chazan B, Raz R, Saliba W. Clostridium difficile and inflammatory bowel disease: role in pathogenesis and implications in treatment. World J Gastroenterol. 2013;19(43):7577–85.
  • Kotwani A, Chaudhury RR, Holloway K. Antibiotic-prescribing practices of primary care prescribers for acute diarrhea in New Delhi, India. Value Health. 2012;15(1):116–9.
  • Pathak P, Pathak A, Marrone G, Diwan V, Lundborg CS. Adherence to treatment guidelinesfor acute diarrhea in children up to 12 years in Ujjain, India—a crosssectional prescription analysis. BMC Infec Dis 2011;11:32.
  • JR Brestoff, D Artis. Commensal bacteria at the interface of host metabolism and the immune system. Nat Immunol. 2013;14:676–84.
  • Buffie CG, Pamer EG. Microbiota-mediated colonization resistance against intestinal pathogens. Nat Rev Immunol. 2013;13(11):790-801.
  • Chen SY, Tsai CN, Lee YS, Lin CY, Huang KY, Chao HC, et al. Corrigendum: Intestinal microbiome in children with severe and complicated acute viral gastroenteritis. Sci Rep. 2017;7:46130.

Uygunsuz antibiyotik kullanımı akut gastroenteritte hastanede kalış süresini uzatabilir mi?

Year 2018, Volume: 15 Issue: 2, 85 - 91, 14.08.2018

Abstract

Amaç: Bu çalışmanın amacı hastanemize başvuran ve AGE (akut gastroenterit) tanısıyla tedavi edilen hastaları klinik olarak değerlendirmek ve hastanemize başvurmadan önce bu hastalara uygulanan tedavi yöntemlerini araştırmaktır.

Materyal ve Metod: Hastaların klinik kayıtları retrospektif olarak incelendi.

Bulgular: AGE tanısı alan 352 olgu çalışmaya alındı. Hastaların% 61,1'i erkek,% 38,9’u kadındı. Hastaların yaş ortalaması 14,8 ± 19,3 ay idi. AGE tanısı alan ve komorbiditesi bulunmayan 244 hasta kliniğimize başvurmadan önce oral antibiyotik kullanımlarına göre iki gruba ayrılılıp incelendiğinde, ortalama hastanede kalış süresi, oral antibiyotik kullanılmayan grupta oral antibiyotik kullanan gruba göre anlamlı olarak daha kısa bulundu (p <0.001). Oral antibiyotik kullanılmayan grupta ortalama sağlık hizmeti maliyetleri, oral antibiyotik kullanılan gruba göre daha düşüktü.

Sonuç: AGE'li olgularda, ortalama hastanede yatış süresinin uzunluğu cinsiyet, etken patojen ve dehidratasyon varlığından etkilenmemektedir. AGE tedavisinde uygunsuz antibiyotik kullanımının, hastanede kalış süresinin uzamasıyla birlikte sağlık hizmeti maliyetlerini artırabileceği düşünülmüştür.

References

  • Degiuseppe JI. Tendencia de los egresos hospitalarios por enfermedades infecciosas intestinales en niños en Argentina, 2005-2013. Arch Argent Pediatr. 2017;115(4):350-6.
  • Freedman SB, Ali S, Oleszczuk M, Gouin S, Hartling L. Treatment of acute gastroenteritis in children: an overview of systematic reviews of interventions commonly used in developed countries. Evid Based Child Health. 2013;8(4):1123-37.
  • Celik AY, Emiroglu M, Kurtoglu MG, Inci A, Odabas D. Akut Gastroenteritli 0-5 Yaş Arası Çocuklarda Viral Etkenlerin Sıklığının Araştırılması. Türkiye Çocuk Hastalıkları Dergisi, 2016;2:101-6.
  • Liu L, Oza S, Hogan D, Chu Y, Perin J, Zhu J, et al. Global, regional, and national causes of under-5 mortality in 2000- 15: an updated systematic analysis with implications for the sustainable development goals. Lancet. 2016;388(10063):3027–35.
  • Liu L, Johnson H, Cousens S. Global, regional, and national causes of child mortality in 2000-2010: an updated systematic analysis. Lancet. 2012;379(9832):2151-61.
  • Kızılırmak A, Çalışkan E, Temizkan RC. Akut Gastroenteritli Çocuklarda Rotavirus ve Adenovirus SıklığI. Konuralp Tıp Dergisi, 2017;9(2):35-9.
  • Lu L, Zhong H, Su L, Cao L, Xu M, Dong N, et al. Detection and Molecular Characterization of Human Adenovirus Infections among Hospitalized Children with Acute Diarrhea in Shanghai, China, 2006–2011. Can J Infect Dis Med Microbiol. 2017;2017:9304830
  • Urbiztondo I, Bjerrum L, Caballero L, Suarez MA, Olinisky M, Córdoba G. Decreasing Inappropriate Use of Antibiotics in Primary Care in Four Countries in South America-Cluster Randomized Controlled Trial. Antibiotics (Basel). 2017;6(4):38.
  • Devasia RA, Varma JK, Whichard J, Gettner S, Cronquist AB, Hurd S, et al. Antimicrobial use and outcomes in patients with multidrug-resistant and pansusceptible Salmonella newport infections, 2002–2003. Microb Drug Resist. 2005;11(4):371–7.
  • Schnadower D, Tarr P, Gorelick MH, O’Connell K, Roskind CG, Powell EC, et al. Validation of the Modified Vesikari Score in Children with Gastroenteritis in 5 U.S. Emergency Departments. J Pediatr Gastroenterol Nutr. 2013;57(4):514–9.
  • A Falszewska, P Dziechciarz, Szajewska H. The diagnostic accuracy of Clinical Dehydration Scale in identifying dehydration in children with acute gastroenteritis: a systematic review. Eur J Pediatr 2017;176:1021–26.
  • Guarino A, Ashkenazi S, Gendrel D, Lo Vecchio A, Shamir R, Szajewska H; European Society for Pediatric Gastroenterology, Hepatology, and Nutrition; European Society for Pediatric Infectious Diseases. European Society for Pediatric Gastroenterology, Hepatology, and Nutrition/European Society for Pediatric Infectious Diseases evidence-based guidelines for the management of acute gastroenteritis in children in Europe: update 2014. J Pediatr Gastroenterol Nutr. 2014;59(1):132-52.
  • World Health Organization (WHO). Health topics: diarrhea Available at: http://www.who.int/topics/diarrhoea/en/, Date of access: February 26, 2018
  • Alcalá AC, Pérez K, Blanco R, González R, Ludert JE, Liprandi F, et al. Molecular detection of human enteric viruses circulating among children with acute gastroenteritis in Valencia, Venezuela, before rotavirus vaccine implementation. Gut Pathog. 2018;10:6.
  • Bulut Y, Yenişehirli G, Durmaz R. Molecular Epidemiology of Rotavirus Strains in Under Five Children. Indian J Pediatr. 2018;85(5):364-8.
  • Gubruz F, Tezer H, Saylı TR. Etiologic factors and clinical findings oaf patients hospitalized children for acute gastroenteritis: Epidemiologic study. Turkish J Pediatr Dis. 2010; 4(4): 211-8.
  • Oikarinen S, Tauriainen S, Viskari H, Simell O, Knip M, Virtanen S, et al. PCR inhibition in stool samples in relation to age of infants. J Clin Virol 2009;211-4.
  • Selek MB, Bektore B, Karagoz E, Baylan O, Ozyurt M. Distribution of Parasites Detected in Stool Samples of Patients Admitted to Our Parasitology Laboratory during a Three-Year Period between 2012 and 2014. Turkiye Parazitol Derg. 2016;40:137-40.
  • Ahmed T, Khanum H, Uddin MS, Barua P, Arju T, Kabir M, et al. Entamoeba histolytica, giardia lamblia and cryptosporidium spp. infection in children in an urban slum area of Bangladesh. Biores Commun. 2016;2(1):175-81.
  • Ahmad A, Khan MU, Malik S, Mohanta GP, Parimalakrishnan S, Patel I, et al. Prescription patterns and appropriateness of antibiotics in the management of cough/cold and diarrhea in a rural tertiary care teaching hospital. J Pharm Bioallied Sci 2016;8(4):335- 40.
  • Bruzzese E, Giannattasio A, Guarino A. Antibiotic treatment of acute gastroenteritis in children. F1000Research. 2018;7:193-203.
  • Nitzan O, Elias M, Chazan B, Raz R, Saliba W. Clostridium difficile and inflammatory bowel disease: role in pathogenesis and implications in treatment. World J Gastroenterol. 2013;19(43):7577–85.
  • Kotwani A, Chaudhury RR, Holloway K. Antibiotic-prescribing practices of primary care prescribers for acute diarrhea in New Delhi, India. Value Health. 2012;15(1):116–9.
  • Pathak P, Pathak A, Marrone G, Diwan V, Lundborg CS. Adherence to treatment guidelinesfor acute diarrhea in children up to 12 years in Ujjain, India—a crosssectional prescription analysis. BMC Infec Dis 2011;11:32.
  • JR Brestoff, D Artis. Commensal bacteria at the interface of host metabolism and the immune system. Nat Immunol. 2013;14:676–84.
  • Buffie CG, Pamer EG. Microbiota-mediated colonization resistance against intestinal pathogens. Nat Rev Immunol. 2013;13(11):790-801.
  • Chen SY, Tsai CN, Lee YS, Lin CY, Huang KY, Chao HC, et al. Corrigendum: Intestinal microbiome in children with severe and complicated acute viral gastroenteritis. Sci Rep. 2017;7:46130.
There are 27 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Research Article
Authors

Halil Kazanasmaz 0000-0003-4671-4028

Kabil Shermatov This is me 0000-0001-8680-0719

Publication Date August 14, 2018
Submission Date July 16, 2018
Acceptance Date August 10, 2018
Published in Issue Year 2018 Volume: 15 Issue: 2

Cite

Vancouver Kazanasmaz H, Shermatov K. Can inappropriate use of antibiotic prolong the length of hospital stay in acute gastroenteritis?. Harran Üniversitesi Tıp Fakültesi Dergisi. 2018;15(2):85-91.

Harran Üniversitesi Tıp Fakültesi Dergisi  / Journal of Harran University Medical Faculty