Browsing by Author "Sungur, M"

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    Colistin and Acute Renal Failure: A Centre's Experience
    Hür, E; Çetinturk, A; Eminoglu, V; Sungur, M; Tavsan, Ö; Piskinpasa, SV; Severcan, E; Karaca, N; Duman, S
    OBJECTIVE: Colistin is a polymyxin antibiotic with a polypeptide structure and is effective against gram-negative bacilli. Although its use had decreased due to its side effects, it has increased again in recent years, especially for multi-drug resistant Pseudomonas aeruginosa, Klebsiella pneumoniae, Acinetobacter and Enterobacteriaceae. In the present study, patients that received colistin at one center were retrospectively analysed in terms of nephrotoxicity. MATERIAL and METHODS: Patients hospitalized and treated with colistin in the intensive care unit between January 2012 and August 2013 were analyzed. Demographic data; biochemical tests at baseline, daily during hospitalization and after discharge; and the initial, maintenance and total doses of colistin were evaluated. RESULTS: The mean age was 62 +/- 13 (31-86) years for the 27 patients with 17 (63%) males that were followed-up for an average duration of 63 +/- 89 days. During follow-up, 18 patients (66.7%) developed acute renal failure (ARF) and 17 (63%) of died. There were 12 (66.7%) mortalities in the ARF group and 5 (55%) in the group without ARF (p> 0.05). The total colistin dose and leukocyte count were higher in the ARF group with 3.75 +/- 2.34 g and 12.04 +/- 5.05/mm(3) than the non-ARF group at 3.32 +/- 1.86 g and 7.60 +/- 3.7/mm(3) but did not reach statistical significance. CONCLUSION: ARF increases the mortality in ICU patients. Although colistin is an effective therapeutic agent used for resistant infections, we have to avoid higher doses due to its potential side effect of ARF.
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    Evaluation of the therapeutic use of antibiotics in Aegean Region hospitals of Turkey: A multicentric study
    Ozgenç, O; Genç, VE; Ari, AA; Sibel, E; Saçar, S; Ozunlu, H; Akgul, A; Demirturk, N; Çetin, CB; Sungur, M; Coskuner, SA; Avci, M; Ergonul, O
    Purpose: The antibiotic restriction policy has been validated nationwide since February 2003 by the Ministry of Health because the excessive consumption of antimicrobials causes a high cost. The aim of this study was to evaluate the therapeutic use of antibiotics in Aegean Region hospitals and to assess the impact of this nationwide antibiotic restriction policy. This new policy is based on justification that the infectious disease (ID) physicians should be primarily responsible for the prescription of antimicrobials. Materials and Methods: Eight university and government hospitals were included in the study. The criteria of the Council for Appropriate and Rational Antibiotic Therapy (CARAT) were considered. Both patient-based and antibiotic-based analyses were performed. For the analysis of inappropriate use, logistic regression was modeled. Results: Therapeutic use was determined in 540 patients by a total of 29 ID physicians. In the study, 30.2% of the patients were given antimicrobials and empirically started antibiotics accounted for 79% cases of therapeutic antibiotic use, and 60% of those were inappropriate (P = 0.001). The appropriate use of ID level antibiotics (P = 0.000) were very compatible with other antimicrobial groups. Conclusion: The study shows that the Turkish government's new intervention policy on antimicrobial prescribing has been effective.