Browsing by Author "Demirdal, T"

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    Tenofovir alafenamid prophylaxis for the prevention of HBV reactivation in immunosuppressed subjects: a multicenter study
    (CUKUROVA UNIV, FAC MEDICINE) Akar, SS; Sönmez, U; Demirdal, T; Sen, P; Özer, D; Atalay, S; Akyol, D; Mermutluoglu, Ç; Çelen, MK; Yamazhan, T; Pullukçu, H
    Purpose: Reactivation of hepatitis B may be prevented by antiviral therapy in immunosuppressed high risk patients. Entecavir (ETC) and tenofovir disoproksil fumarat (TDF) have been used for a long time and recently introduced tenofovir alafenamid (TAF) seems to be a good alternative with rare side effects. This multicentered study with a large patient population aimed to investigate the effectiveness of tenofovir alafenamid (TAF) in immunsuppressed subjects. Materials and Methods: The records of six training and research hospitals between January 1, 2019 and September 30, 2021 were retrospectively reviewed, and patients who were started antiviral prophylaxis for hepatitis B and followed up for at least 6 months while under immunosuppressive therapy were included in the study. Risk groups were determined according to the immunosuppressive treatment or chemotherapy they received, as well as hepatitis B serology, and were examined in terms of the presence of hepatitis B reactivation and its side effects. Results: The mean age of patients was found as 62.5 +/- 29. Out of 148 patients, 85 (57.4%) received TAF, 63 (42.6%) received either Entecavir (ETC) or tenofovir disoproksil fumarat (TDF). The majority (83.1%) was found as HBsAg (-) antiHBc (+) and 16.9% was HBsAg (+). HBV DNA was traced in 36% of chronic HBV patients. Most of the patients (69.6%) were receiving immunospuppressives for treatment of a haematologic malignancy and 89.2% was in the high risk treatment group. There was no difference between TAF and the other drugs in terms of risks. Reactivation was not seen in any of the treatment groups. Conclusion: TAF is as effective as TDF and ETC when used for prophylaxis in immunosuppressed HBV patients. Side effects on kidney and bone are not seen in TAF treatment groups which will probably play a role in preferring this new drug.
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    Impact of antimicrobial drug restrictions on doctors' behaviors
    (Tubitak Scientific & Technological Research Council Turkey) Karabay, O; Hosoglu, S; Güçlü, E; Akalin, S; Altay, FA; Aydin, E; Ceylan, B; Çelik, A; Çelik, I; Demirdal, T; Demirli, K; Erben, N; Erkorkmaz, Ü; Erol, S; Evirgen, Ö; Gönen, I; Güner, AE; Güven, T; Kadanali, A; Koçoglu, ME; Kökoglu, OF; Küçükbayrak, A; Sargin, F; Sünnetçioglu, M; Senol, S; Isikgöz Tasbakan, M; Tekin, R; Turhan, V; Yilmaz, G; Dede, B
    Background/aim: Broad-spectrum antibiotics have become available for use only with the approval of infectious disease specialists (IDSs) since 2003 in Turkey. This study aimed to analyze the tendencies of doctors who are not disease specialists (non-IDSs) towards the restriction of antibiotics. Materials and methods: A questionnaire form was prepared, which included a total of 22 questions about the impact of antibiotic restriction (AR) policy, the role of IDSs in the restriction, and the perception of this change in antibiotic consumption. The questionnaire was completed by each participating physician. Results: A total of 1906 specialists from 20 cities in Turkey participated in the study. Of those who participated, 1271 (67.5%) had <= 5 years of occupational experience (junior specialists = JSs) and 942 (49.4%) of them were physicians. Specialists having >5 years of occupational experience in their branch expressed that they followed the antibiotic guidelines more strictly than the JSs (P < 0.05) and 755 of physicians (88%) and 720 of surgeons (84.6%) thought that the AR policy was necessary and useful (P < 0.05). Conclusion: This study indicated that the AR policy was supported by most of the specialists. Physicians supported this restriction policy more so than surgeons did.