ALT SOLUNUM YOLU ENFEKSİYONLARINDA ANTİBİYOTİK TEDAVİSİNİN UYGUNLUĞU: KESİTSEL BİR ÇALIŞMA

Öz

Amaç: Bu çalışma, alt solunum yolu enfeksiyonu (ASYE) tanısı ile izlenen hastalarda antibiyotik tedavilerinin ve taburculuk reçetelerinin uygunluğunu İlaç Uygunluk İndeksi (Medication Appropriateness Index, MAI) kriterlerine göre değerlendirmeyi amaçlamaktadır. Yöntem: Ocak 2022–Ocak 2024 tarihleri arasında üçüncü basamak bir eğitim ve araştırma hastanesinde retrospektif, kesitsel tasarımda yürütülen çalışmaya, toplum kökenli pnömoni, akut/kronik bronşit, KOAH ve astımın enfeksiyon kaynaklı alevlenmeleri nedeniyle antibiyotik tedavisi alan 111 hasta dahil edildi. Reçetelerin uygunluğu, iki uzman hekim tarafından MAI’nin on değerlendirme alanına göre puanlandı. Bulgular: Tüm reçetelerde antibiyotik endikasyonu, etkililik, dozaj ve talimatların doğruluğu açısından tam uygunluk (%100) saptandı. Klinik olarak anlamlı ilaç–ilaç veya ilaç–hastalık etkileşimi görülmedi. Gereksiz antibiyotik duplikasyonu %4,5 oranında saptandı. Maliyet uygunluğu %68 idi. Yatışta monoterapi oranı yüksek olup, taburculukta daha dar spektrumlu ve maliyet-etkin antibiyotiklere geçiş eğilimi gözlendi. Sonuç: MAI değerlendirmesine göre, antibiyotik reçeteleme sürecinde genel klinik uygunluk yüksek bulunmuştur. Ancak gereksiz duplikasyonun azaltılması ve maliyet-etkin seçeneklerin daha yaygın tercih edilmesi, akılcı antibiyotik kullanımını daha da güçlendirecektir.

Anahtar Kelimeler

• Alt Solunum Yolu Enfeksiyonu
• antibiyotik uygunluğu
• İlaç Uygunluk İndeksi

Appropriateness of Antibiotic Treatment in Lower Respiratory Tract Infections: A Cross-Sectional Study

Öz

Objective: This study aimed to evaluate the appropriateness of antibiotic therapy and discharge prescriptions in patients with lower respiratory tract infections (LRTIs) using the Medication Appropriateness Index (MAI) criteria. Methods: A retrospective cross-sectional study was conducted between January 2022 and January 2024 at a tertiary training and research hospital. A total of 111 patients diagnosed with community-acquired pneumonia, acute/chronic bronchitis, or infectious exacerbations of COPD and asthma were included. Prescriptions were evaluated independently by two physicians based on the ten MAI domains. Results: All prescriptions were fully appropriate regarding indication, effectiveness, dosage, and directions (100%). No clinically significant drug–drug or drug–disease interactions were detected. Unnecessary antibiotic duplication occurred in 4.5% of cases, and cost appropriateness was achieved in 68%. Monotherapy was predominant during hospitalization, while a trend toward narrower-spectrum and more cost-effective regimens was observed at discharge. Conclusion: According to MAI assessment, overall clinical appropriateness of antibiotic prescribing was high. Reducing unnecessary duplication and promoting cost-effective alternatives may further strengthen rational antibiotic use and antimicrobial stewardship practices.

Anahtar Kelimeler

• Lower respiratory tract infection
• Antibiotic appropriateness
• Medication Appropriateness Index (MAI)

Kaynakça

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