Ampirik tüberküloz tedavisi başlama hızımız
Küçük Resim Yok
Tarih
2023
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Trakya Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Tüberküloz insanlığın en eski düşmanlarından biridir. Önlenebilir olmasına rağmen halen her yıl 1.5 milyon kişinin ölümüyle sonuçlanmaktadır. Özellikle gelişmekte olan ülkelerde yaşanan hasta gecikmesi, tanı gecikmesi, tedavinin sürekliliği, İnsan İmmün Yetmezlik Virüsü, Coronavirüs gibi ek salgınlar ve açlık, kuraklık gibi insanlık sorunları sorunu karmaşıklaştırmaktadır. Tanı her zaman objektif kanıta dayandırılamamakta ve ampirik tedavi halen bütün dünyada kullanılmaya devam edilmektedir. Bu çalışmada Trakya Üniversitesi Tıp Fakültesi Göğüs Hastalıkları Kliniği tarafından tüberküloz tedavisi başlanan olguları değerlendirerek, ampirik tedavi başlama hızını ve ampirik tedaviye yönlendiren etmenleri belirlemeyi hedefledik. Çalışma evrenimiz 01.06.2013-01.03.2020 tarih aralığında Trakya Üniversitesi Tıp Fakültesi Göğüs Hastalıkları Kliniği'ne başvurup ayaktan ve hastane yatışı ile tüberküloz tedavisi başlanan hastalardan oluşmaktadır. Retrospektif olarak taranan olguların bilgileri hastane bilgi sistemi, e-nabız ve ilgili verem savaş dispanserlerinden edinildi. Olguların tedavi bitiminden sonra en az 2 yıllık izlemleri dahil tüm verileri iki ayrı göğüs hastalıkları uzmanı eşliğinde değerlendirildi. Çalışmamızın sonucunda 2013-2020 yılları arasındaki ardışık tüberküloz tedavisi başlanan 368 olgunun 120'sine (%32.6) tedavinin ampirik bir şekilde başlandığını saptadık. Ampirik tedavi başlananlar içinde doğru tanı koyma oranı %96.5 olarak bulduk. Ampirik veya kanıta dayalı tedavi başlanan olgular arasında başlıca demografik ve klinik özellikler açısından belirgin bir fark saptamadık. Sonuç olarak kliniğimizde, hızlı tanı testlerinin yokluğunda ampirik tedavinin başarılı bir şekilde kullanıldığını değerlendirdik. Ancak tanıya hızlı ulaşma, kanıta dayalı tedavi yapma gereksinimleri özellikle ilaç dirençlerindeki değişimler ile değerlendirilerek hızlı tanı testlerinin yaygınlaştırılması yararlı olabilir. Anahtar sözcükler: ampirik tüberküloz tedavisi, hızlı tanı testleri
Tuberculosis is one of oldest enemy of human being. Although preventable, it still results in 1.5 million deaths each year. Especially in developing countries, patient delay, delay in diagnosis, continuity of treatment, additional epidemics such as Human Immundeficiency Virus and Coronavirus, and human problems such as hunger and drought complicate the problem. The diagnosis cannot always be based on objective evidence and empirical treatment is still used all over the world. In this study, we aimed to determine the rate of initiation of empirical treatment and the factors leading to empirical treatment by evaluating the patients who were started tuberculosis treatment by Trakya University Medical Faculty Chest Diseases Clinic. Our study population consists of patients who applied to the Trakya University Faculty of Medicine Chest Diseases Clinic between 01.06.2013 and 01.03.2020 and were treated for tuberculosis with outpatient and hospitalization. The information of the retrospectively scanned cases was obtained from the hospital information system, e-pulse and related tuberculosis dispensaries. All data of the cases, including at least 2 years of follow-up after the end of the treatment, were evaluated in the presence of two different chest diseases specialists. As a result of our study, we found that 120 (32.6%) of 368 cases of sequential tuberculosis treatment between 2013 and 2020 were started empirically. We found the correct diagnosis rate to be 96.5% among those who started empirical treatment. We did not detect any significant difference in terms of demographic and clinical characteristics between the cases in which empirical or evidence-based treatment was initiated. In conclusion, we evaluated the successful use of empirical therapy in the absence of rapid diagnostic tests in our clinic. However, it may be beneficial to expand rapid diagnostic tests by evaluating the need for rapid diagnosis and evidence-based treatment, especially with changes in drug resistance. Key words: emprical tuberculosis treatment, rapid diagnostics tests
Tuberculosis is one of oldest enemy of human being. Although preventable, it still results in 1.5 million deaths each year. Especially in developing countries, patient delay, delay in diagnosis, continuity of treatment, additional epidemics such as Human Immundeficiency Virus and Coronavirus, and human problems such as hunger and drought complicate the problem. The diagnosis cannot always be based on objective evidence and empirical treatment is still used all over the world. In this study, we aimed to determine the rate of initiation of empirical treatment and the factors leading to empirical treatment by evaluating the patients who were started tuberculosis treatment by Trakya University Medical Faculty Chest Diseases Clinic. Our study population consists of patients who applied to the Trakya University Faculty of Medicine Chest Diseases Clinic between 01.06.2013 and 01.03.2020 and were treated for tuberculosis with outpatient and hospitalization. The information of the retrospectively scanned cases was obtained from the hospital information system, e-pulse and related tuberculosis dispensaries. All data of the cases, including at least 2 years of follow-up after the end of the treatment, were evaluated in the presence of two different chest diseases specialists. As a result of our study, we found that 120 (32.6%) of 368 cases of sequential tuberculosis treatment between 2013 and 2020 were started empirically. We found the correct diagnosis rate to be 96.5% among those who started empirical treatment. We did not detect any significant difference in terms of demographic and clinical characteristics between the cases in which empirical or evidence-based treatment was initiated. In conclusion, we evaluated the successful use of empirical therapy in the absence of rapid diagnostic tests in our clinic. However, it may be beneficial to expand rapid diagnostic tests by evaluating the need for rapid diagnosis and evidence-based treatment, especially with changes in drug resistance. Key words: emprical tuberculosis treatment, rapid diagnostics tests
Açıklama
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Tıpta Uzmanlık
Tıpta Uzmanlık
Anahtar Kelimeler
Göğüs Hastalıkları, Chest Diseases
