Browsing by Author "Kepenekli, E"

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    Antifungal consumption, indications and selection of antifungal drugs in paediatric tertiary hospitals in Turkey: Results from the first national point prevalence survey
    Çaglar, I; Devrim, I; Özdemir, H; Sahbudak, Z; Sönmez, G; Buyukcam, A; Gulhan, B; Kara, A; Aygun, DF; Bayram, N; Celebi, S; Çetin, B; Nepesov, MI; Yilmaz, AT; Kepenekli, E; Çiftdogan, DY; Acar, MK; Yayla, BC; Okumus, C; Ecevit, Z; Hatipoglu, N; Kuyucu, N; Kosker, M; Sen, S; Karbuz, A; Sutcu, M; Duramaz, BB; Özen, M; Çiftçi, E; Alabaz, D; Kurugol, Z; Kara, A; Kanik, S; Kilic, O; Oncel, S; Somer, A; Tapisiz, A; Belet, N; Akcan, ÖM; Türel, Ö; Ozkaya, A; Tezer, H; Cengiz, AB; Ince, E; Camcioglu, Y; Kocabas, E; Arisoy, ES; Salman, N
    Objectives: The aim of this point prevalence survey was to evaluate the consumption, indications and strategies of antifungal therapy in the paediatric population in Turkey. Methods: A point prevalence study was performed at 25 hospitals. In addition to general data on paediatric units of the institutes, the generic name and indication of antifungal drugs, the presence of fungal isolation and susceptibility patterns, and the presence of galactomannan test and high-resolution computed tomography (HRCT) results were reviewed. Results: A total of 3338 hospitalised patients were evaluated. The number of antifungal drugs prescribed was 314 in 301 patients (9.0%). Antifungal drugs were mostly prescribed in paediatric haematology and oncology (PHO) units (35.2%), followed by neonatal ICUs (NICUs) (19.6%), paediatric services (18.3%), paediatric ICUs (PICUs) (14.6%) and haematopoietic stem cell transplantation (HSCT) units (7.3%). Antifungals were used for prophylaxis in 147 patients (48.8%) and for treatment in 154 patients (50.0%). The antifungal treatment strategy in 154 patients was empirical in 77 (50.0%), diagnostic-driven in 29 (18.8%) and targeted in 48 (31.2%). At the point of decision-making for diagnostic-driven antifungal therapy in 29 patients, HRCT had not been performed in 1 patient (3.4%) and galactomannan test results were not available in 12 patients (41.4%). Thirteen patients (8.4%) were receiving eight different antifungal combination therapies. Conclusion: The majority of antifungal drugs for treatment and prophylaxis were prescribed in PHO and HSCT units (42.5%), followed by ICUs. Thus, antifungal stewardship programmes should mainly focus on these patients within the availability of diagnostic tests of each hospital. (C) 2018 International Society for Chemotherapy of Infection and Cancer. Published by Elsevier Ltd. All rights reserved.
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    Epidemiological, Clinical, and Laboratory Features of Children With COVID-19 in Turkey
    Karbuz, A; Akkoc, G; Demirdag, TB; Ciftdogan, DY; Ozer, A; Cakir, D; Torun, SH; Kepenekli, E; Erat, T; Dalgic, N; Ilbay, S; Karaaslan, A; Erdeniz, EH; Aygun, FD; Bozdemir, SE; Hatipoglu, N; Emiroglu, M; Bal, ZS; Ciftci, E; Bayhan, GI; Aydin, ZGG; Demir, SO; Kilic, O; Hacimustafaoglu, M; Okur, DS; Sen, S; Yahsi, A; Akturk, H; Cetin, B; Sutcu, M; Kara, M; Uygun, H; Kara, TT; Korukluoglu, G; Akgun, O; èstundag, G; Mis, MD; Sali, E; Kaba, O; Yakut, N; Kilic, O; Kanik, MK; Cetin, C; Dursun, A; Cicek, M; Kockuzu, E; Sevketoglu, E; Alkan, G; Ozenen, GG; Ince, E; Baydar, Z; Ozkaya, AK; Ovali, HF; Tekeli, S; Celebi, S; Cubukcu, B; Bal, A; Khalilova, F; Kose, M; Hatipoglu, HU; Dalkiran, T; Turgut, M; Altas, AB; Duru, HNS; Aksay, A; Saglam, S; Yanartas, MS; Ergenc, Z; Akin, Y; Kar, YD; Sahin, S; Tuteroz, SK; Bilen, NM; Ozdemir, H; Senoglu, MC; Kucukalioglu, BP; Besli, GE; Kara, Y; Turan, C; Demirtas, BS; Celikyurt, A; Cosgun, Y; Elevli, M; Sahin, A; Oguz, SB; Somer, A; Karadag, B; Demirhan, R; Dagi, HT; Kurugol, Z; Taskin, EC; Sahiner, A; Yesil, E; Keles, YE; Sarikaya, R; Eralp, EE; Ozkinay, F; Konca, HK; Yilmaz, S; Gokdemir, Y; Arga, G; Ozen, S; Coksuer, F; Vatansever, G; Tezer, H; Kara, A
    Objectives: The aim of this study is to identify the epidemiological, clinical, and laboratory features of coronavirus disease 2019 (COVID-19) in children. Methods: A retrospective study was conducted by pediatric infectious disease specialists from 32 different hospitals from all over Turkey by case record forms. Pediatric cases who were diagnosed as COVID-19 between March 16, 2020, and June 15, 2020 were included. Case characteristics including age, sex, dates of disease onset and diagnosis, family, and contact information were recorded. Clinical data, including the duration and severity of symptoms, were also collected. Laboratory parameters like biochemical tests and complete blood count, chest X-ray, and chest computed tomography (CT) were determined. Results: There were 1,156 confirmed pediatric COVID-19 cases. In total, male cases constituted 50.3% (n = 582) and females constituted 49.7% (n = 574). The median age of the confirmed cases was 10.75 years (4.5-14.6). Of the total cases, 90 were younger than 1 year of age (7.8%), 108 were 1-3 years of age (9.3%), 148 were 3-6 years of age (12.8%), 298 were 6-12 years of age (25.8%), 233 were 12-15 years of age (20.2%), and 268 cases were older than 15 years of age (23.2%). The most common symptom of the patients at the first visit was fever (50.4%) (n = 583) for a median of 2 days (IQR: 1-3 days). Fever was median at 38.4 degrees C (38.0-38.7 degrees C). The second most common symptom was cough (n = 543, 46.9%). The other common symptoms were sore throat (n = 143, 12.4%), myalgia (n = 141, 12.2%), dyspnea (n = 118, 10.2%), diarrhea (n = 112, 9.7%), stomachache (n = 71, 6.1%), and nasal discharge (n = 63, 5.4%). When patients were classified according to disease severity, 263 (22.7%) patients were asymptomatic, 668 (57.7%) patients had mild disease, 209 (18.1%) had moderate disease, and 16 (1.5%) cases had severe disease. One hundred and forty-nine (12.9%) cases had underlying diseases among the total cases; 56% of the patients who had severe disease had an underlying condition (p < 0.01). The need for hospitalization did not differ between patients who had an underlying condition and those who do not have (p = 0.38), but the need for intensive care was higher in patients who had an underlying condition (p < 0.01). Forty-seven (31.5%) of the cases having underlying conditions had asthma or lung disease (38 of them had asthma). Conclusions: To the best of our knowledge, this is one of the largest pediatric data about confirmed COVID-19 cases. Children from all ages appear to be susceptible to COVID-19, and there is a significant difference in symptomatology and laboratory findings by means of age distribution.