BULGARİSTAN’IN VARNA KENTİNDEKİ KADIN HASTALIKLARI VE DOĞUM HASTANESİNDE ANTİBİYOTİK KULLANIM EĞİLİMLERİ (2017–2023): RETROSPEKTİF BİR ANALİZ

Öz

Amaç: Antimikrobiyal direnç (AMR), hastanelerde uygunsuz antibiyotik reçetelendirilmesinin önemli bir belirleyici faktör olarak kabul edildiği, küresel sağlık açısından en büyük tehditlerden birini oluşturmaktadır. Bu çalışma, COVID-19 pandemisi yıllarını da kapsayacak şekilde, 2017–2023 döneminde Bulgaristan’ın Varna kentinde bulunan “Prof. Dr. Dimitar Stamatov” Kadın Hastalıkları ve Doğum Hastanesi’nde antibiyotik tüketim eğilimlerini değerlendirmeyi amaçlamaktadır. Gereç ve Yöntem: Geriye dönük gözlemsel bir analiz, hastanenin tam antimikrobiyal kullanım veritabanı kullanılarak gerçekleştirilmiştir. Antibiyotikler, WHO ATC/DDD metodolojisine göre sınıflandırılmış ve dört klinik birimde (Yoğun Bakım Ünitesi, Jinekoloji Servisi, Doğum Servisi ve Yüksek Riskli Gebelik Servisi) 100 yatak-gün başına tanımlanmış günlük doz (DDD) olarak ifade edilmiştir. Antibiyotik kullanımı ayrıca WHO AWaRe çerçevesine göre Erişim, İzlem ve Rezerv gruplarına ayrılmıştır. Sonuç ve Tartışma: Bulgular, sefalosporinler, florokinolonlar ve metronidazolün en sık reçete edilen ajanlar olduğunu göstermektedir. 2020 yılında, COVID-19 pandemisinin başlangıcına denk gelen dönemde antibiyotik kullanımında bir artış gözlenmiş, bunu ise kademeli bir azalma izlemiştir. Genel olarak antibiyotiklerin %58.37’si Erişim grubuna, %4.63’ü İzlem grubuna ait olup, Rezerv grubunda kullanım kaydedilmemiştir. Tutarlı olarak düşük ve düzenli antibiyotik tüketimi, sürveyansın, sıkı protokollerin ve kurumsal düzeyde akılcı antibiyotik kullanımına bağlılığın önemini vurgulamaktadır.

Anahtar Kelimeler

• Antibiyotik tüketimi
• antimikrobiyal direnç
• COVID-19
• hastane
• jinekoloji pratiği

TRENDS IN ANTIBIOTIC USAGE AT A SPECIALIZED OBSTETRICS AND GYNECOLOGY HOSPITAL IN VARNA, BULGARIA (2017–2023): A RETROSPECTIVE ANALYSIS

Öz

Objective: Antimicrobial resistance (AMR) poses one of the greatest global health challenges, with inappropriate antibiotic prescribing in hospitals recognized as a major driver. This study aimed to evaluate antibiotic consumption trends in the Specialized Hospital for Obstetrics and Gynecology for Active Treatment “Prof. Dr. Dimitar Stamatov” (SHOGAT), Varna, Bulgaria, over a seven-year period (2017–2023), including the COVID-19 pandemic years. Material and Method: A retrospective observational analysis was performed using the hospital’s complete antimicrobial usage database. Antibiotics were classified according to the WHO ATC/DDD methodology and expressed as defined daily doses (DDD) per 100 bed-days across four wards: Intensive Care Unit, Gynecology Ward, Maternity Ward, and High-Risk Pregnancy Ward. Classification of antibiotic use followed the WHO AWaRe framework into Access, Watch, and Reserve groups. Result and Discussion: The results demonstrate that cephalosporins, fluoroquinolones, and metronidazole were the most commonly prescribed agents, with a peak in total antibiotic use during 2020, coinciding with the onset of the COVID-19 pandemic, followed by a gradual decline. Overall, 58.37% of antibiotics belonged to the Access group, while 41.63% were from the Watch group; no use of Reserve antibiotics was recorded. The consistently low and well-regulated consumption underscores the importance of surveillance, strict protocols, and institutional commitment to rational antibiotic use.

Anahtar Kelimeler

• Аntibiotic consumption
• аntimicrobial resistance
• COVID-19
• gynecology practice
• hospital

Kaynakça

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