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Copyright of Journal of Ankara University Faculty of Medicine / Ankara Üniversitesi Tip Fakültesi Mecmuasi is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Broad-spectrum empirical antimicrobials are frequently prescribed for patients with coronavirus disease 2019 (COVID-19) despite the lack of evidence for bacterial coinfection. Aims: We aimed to cross-sectionally determine the frequency of antibiotics use, type of antibiotics prescribed, and the factors influencing antibiotics use in hospitalized patients with COVID-19 confirmed by polymerase chain reaction. Study Design: The study was a national, multicenter, retrospective, and single-day point prevalence study. Methods: This was a national, multicenter, retrospective, and singleday point-prevalence study, conducted in the 24-h period between 00:00 and 24:00 on November 18, 2020, during the start of the second COVID-19 peak in Turkey. Results: A total of 1500 patients hospitalized with a diagnosis of COVID-19 were included in the study. The mean age ± standard deviation of the patients was 65.0 ± 15.5, and 56.2% (n = 843) of these patients were men. Of these hospitalized patients, 11.9% (n = 178) were undergoing invasive mechanical ventilation or ECMO. It was observed that 1118 (74.5%) patients were receiving antibiotics, of which 416 (37.2%) were prescribed a combination of antibiotics. In total, 71.2% of the patients had neither a clinical diagnosis nor microbiological evidence for prescribing antibiotics. In the multivariate logistic regression analysis, hospitalization in a state hospital (p < 0.001), requiring any supplemental oxygen (p = 0.005), presence of moderate/diffuse lung involvement (p < 0.001), C-reactive protein > 10 ULT coefficient (p < 0.001), lymphocyte count < 800 (p = 0.007), and clinical diagnosis and/or confirmation by culture (p < 0.001) were found to be independent factors associated with increased antibiotic use. Conclusion: The necessity of empirical antibiotics use in patients with COVID-19 should be reconsidered according to their clinical, imaging, and laboratory findings. [ABSTRACT FROM AUTHOR]

Copyright of Mediterranean Journal of Infection, Microbes & Antimicrobials is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Mediterranean Journal of Infection, Microbes & Antimicrobials is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Mediterranean Journal of Infection, Microbes & Antimicrobials is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Mediterranean Journal of Infection, Microbes & Antimicrobials is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To analyze the value of autopsy reports for determining the cause of maternal deaths in Turkey. Material and Methods: In this descriptive retrospective study, the case files of 992 maternal deaths, except for accidental causes, that occurred in Turkey between 2012 and 2016 were reviewed. An autopsy examination was performed in 177 (17.8%) of the cohort. When the files were reviewed, maternal descriptive data and the cause of maternal mortality according to the autopsy reports were recorded. Results: The mean age at death was 31.5±6.6 years. No exact cause of maternal death was identified after autopsy in 44 (24.9%) of the 177 cases. An exact cause of death could be determined in 133 (75.1%); 34.5% (n=61) were due to direct causes, and 40.7% (n=72) were due to indirect causes. The leading direct causes of maternal deaths were obstetric hemorrhage (13.0%) and obstetric (pulmonary and amniotic fluid) embolism (12.4%). The main cause among the indirect causes was ruptured aortic aneurysm and/or dissection of aorta (8.5%). Among the subjects with no clinical diagnosis based on the clinical course before death (n=96), the exact cause of death could not be determined at autopsy in 19 (19.8%) cases. The exact or possible cause of death was identified at autopsy in 80.3% (n=77) cases with no clinical diagnosis. Among the cases who had antemortem diagnoses based on the clinical course (n=81), the final diagnosis at autopsy was compatible with the clinical diagnosis in 48 (59.3%) subjects. Conclusion: Maternal autopsy examination provides an exact cause of death in most cases and is still a valuable tool for understanding the cause of maternal mortality. [ABSTRACT FROM AUTHOR]

Copyright of Mediterranean Journal of Infection, Microbes & Antimicrobials is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Adherence to medication is an important aspect of preventing drug resistance and treatment failure in patients receiving nucleos(t)ide analogues for chronic hepatitis B. Aims: To assess adherence to nucleoside/nucleotide analogues in chronic hepatitis B treatment and to determine factors associated with non-adherence. Study Design: Cross-sectional study. Methods: The study enrolled 85 chronic hepatitis B patients who had been receiving nucleoside/nucleotide analogues for ≥3 months. A questionnaire was completed by patients themselves, and adherence was evaluated based on patients' self-reporting. The use of at least 95% of the drugs in the previous month was considered as adequate adherence. Results: Adherence was adequate in 82.4% of patients. Female gender (p=0.003), unemployment (p=0.041) and lower monthly family income (p=0.001) were related to lower adherence. Better adherence was significantly linked to adequate basic knowledge regarding chronic hepatitis B (p=0.049), longer treatment duration than 12 months (p<0.001), previous use of other medications for chronic hepatitis B (p=0.014) and regular follow-up by the same physician (p<0.001). Conclusion: Counselling patients about their disease state and the consequences of non-adherence is an important intervention for enhancing adherence. Naïve patients should be followed up more frequently to reinforce adherence. [ABSTRACT FROM AUTHOR]

Objective: To analyze maternal deaths in Turkey due to hypertensive disorders. Material and Methods: In this retrospective study 812 maternal deaths were analyzed. Maternal demographic features, presence of antenatal care, medical and obstetric history, mode of delivery, and use emergency antihypertensive therapy were recorded. The delay model for each case was investigated. Results: Hypertensive disorders accounted for 15.5% (n= 126) out of all maternal mortality. They were the third most frequent cause among all causes and the 2nd among direct causes of maternal deaths. Sixty-one (48.4%) cases were in severe preeclampsia or pre-existing hypertensive disorder with increased/superimposed proteinuria, 30.1% were in eclampsia, 9.5% cases were diagnosed as hemolysis, elevated liver enzymes, low platelet count syndrome, and 11.1% in pre-existing hypertension complicating pregnancy, childbirth, and puerperium without increased or superimposed proteinuria. The median age was 32 years, 37.3% women were > 35 years. All deaths except for 2 cases occurred during the postpartum period. Twenty-three percent of deaths occurred in the first 48 hours postpartum, and 51.6% between 8-42 days. Intracranial hemorrhage was the major final cause of death with a rate of 41.3%. With the exception of fifteen patients with intracranial hemorrhage, emergency antihypertensive agents were not implemented in optimal dose and/or duration. A first and/or third delay was identified in 36.5% of cases. Conclusion: Approximately one third of maternal death due to hypertensive disorders could be prevented. The importance of acute antihypertensive treatment should be emphasized because of most frequent cause of death was intracranial hemorrhage. [ABSTRACT FROM AUTHOR]

Copyright of Viral Hepatitis Journal / Viral Hepatit Dergisi is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Giriş: Antibiyotikler doğru kullanıldıklarında, enfeksiyon hastalıkları tedavisinde kritik öneme sahiptir. Ancak mortalite ve morbiditenin azaltılması için uygun spektrumda antibiyotik seçimi ne derece önemli ise bu ilaçlara bağlı gelişebilecek advers olayların tahmin edilmesi de o derece önem arz etmektedir. Bu nedenle yaptığımız çalışmada amacımız, hastanede yatarak antibiyotik tedavisi alan hastalarda görülen advers olayları Dünya Sağlık Örgütü’nün belirlediği kriterlere göre saptayıp risk gruplarını belirleyerek tedaviye başlamadan önce öngörülebilirliğini artırmaktır. Ayrıca bu advers olayları sorumlu tutulan ilacın kısa ürün bilgisi ile kıyaslayarak farmakovijilans ve advers olay bildirimine yönelik farkındalığı artırmak ve önemini vurgulamaktır. Gereç ve Yöntem: Çalışmamızda 1 Ocak 2019 ile 31 Aralık 2020 tarihleri arasında Sağlık Bilimleri Üniversitesi, Ankara Dışkapı Yıldırım Beyazıt Eğitim ve Araştırma Hastanesi, Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Servisinde yatarak oral veya intravenöz antibiyotik tedavisi alan 776 hasta çalışmaya dahil edildi. Görülen olası advers olaylar içerisinden DSÖ-UMC kriterlerince ‘kesin’ veya ‘muhtemel’ kategorisinde saptananlar incelendi. ‘Kesin’ veya ‘muhtemel’ advers olay gelişen 125 hasta olgu grubu, advers olay gelişmeyen 651 hasta da kontrol grubu olarak alındı. Ayrıca bu advers olaylar, her bir sorumlu tutulan antibiyotiğin kısa ürün bilgisinde belirtilen oranlar ile kıyaslandı. Bulgular: Verilerin değerlendirilmesiyle antibiyotiklere bağlı advers olay görülme sıklığı %16,1 olarak bulunmuştur. Advers olayların görülmesini artıran risk faktörlerine yönelik yapılan çok değişkenli analiz sonucunda ek hastalık sayısı (p<0,001), antibiyotik tedavisi öncesinde hastanın rutin kullandığı ilaç sayısı (p<0,001) ve antibiyotik maruziyet günü (p<0,001) bağımsız risk faktörleri olarak saptanmıştır (p<0,001). Advers olaylardan en fazla trombositopeni görülürken bunu akut böbrek hasarı ve deri döküntüsü takip etmektedir. Antibiyotiklerin kullanım sıklığına göre bakıldığında en yüksek oranda advers olay sırasıyla kolistin, gentamisin ve trimetoprimsulfametoksazol kullanımında saptanmıştır. Sonuç: Çalışmamızda hastaların %16’sında kullanılan antibiyotiğe bağlı advers olay geliştiği ve ek hastalık sayısı, polifarmasi ve antibiyotik maruziyet gününün advers olay gelişmesinde önemli risk faktörleri oldukları saptanmıştır. Antibiyotik kullanımının yarar ve zarar oranlarının klinisyenler tarafından gözetilmesi ve olası risk faktörleri olan hastalarda antibiyotik seçimi, süresi ve gerekliliğinin daha detaylı değerlendirilmesinin önemi olacağını düşünmekteyiz. Ayrıca akılcı antibiyotik kullanımı ve farmakovijilans çalışmalarının yaygınlaştırılması ile antibiyotiklere bağlı karşılaşılabilecek advers olayların öngörülebilmesi veya azaltılması bu sayede mortalite ve morbiditenin azaltılmasının mümkün olabileceği kanaatindeyiz. [ABSTRACT FROM AUTHOR]

Copyright of Mediterranean Journal of Infection, Microbes & Antimicrobials is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Mediterranean Journal of Infection, Microbes & Antimicrobials is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Mediterranean Journal of Infection, Microbes & Antimicrobials is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Mediterranean Journal of Infection, Microbes & Antimicrobials is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Mediterranean Journal of Infection, Microbes & Antimicrobials is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Mediterranean Journal of Infection, Microbes & Antimicrobials is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Giriş: Tüberküloz (TB) tedavisi sırasında görülen yan etkiler hastanın hayatını tehdit edici boyutta olabilir, ek ilaç kullanımı gerektirebilir, bir veya daha fazla sayıda TB ilacının tedavi rejiminden çıkarılmasına neden olabilir. Sunumumuzda TB tedavisinde birden fazla ilaca yan etki görülen milier TB olgusunun yönetimi ele alındı. Olgu: Hematüri ve ateş şikayeti ile dış merkeze başvurduğunda önce üriner sonra milier TB tanısı alan 38 yaşındaki erkek hastaya birinci seçenek olan dörtlü tedavi [izoniazid (H), rifampisin (R), pirazinamid (Z), etambutol (E)] başlanmış olup, bu tedavinin ikinci gününde bilirubinlerinde ani artış (direkt bilirubin; 19 mg/dl, total bilirubin; 23 mg/dl) olması üzerine ilaç yan etkisi olarak değerlendirilerek anti-TB tedavisi kesilerek merkezimize sevk edilmiştir. Servisimize yatışı sonrasında hastanın tedavisi E 1500 mg, sikloserin (CYC), moksifloksasin 400 mg, streptomisin (SM) 1 gr olarak düzenlendi. İkinci günde nötropenik olarak izlemine devam edilen hastaya sepsis tanısı ile sefepim 3x2 gr, linezolid (LNZ) 2x600 mg başlandı, yedi gün verilerek kesildi. İkinci basamak anti-TB tedavinin üçüncü haftasında halen ateş yüksekliğinin devam etmesi nedeni ile ateş etiyolojisine yönelik tetkikleri tekrarlandı, TB dışında neden saptanamadı. Anti-TB tedavinin 30. gününde tedaviye R eklendi, bir hafta süresinde yan etki gözlenmedi. R kullanılabilir olduğundan SM tedaviden çıkarıldı. Otuz yedinci gün tedavisine H eklendi ancak üçüncü gün itibariyle AST/ALT değeri yükselmeye (AST: 199 U/l, ALT: 46 U/l) başlaması nedeni ile H kesildi. Anti-TB tedavinin 55. gününde ateş yüksekliği halen devam ettiği için tedavisine LNZ eklendi. Hastanın daha önceki LNZ kullanımı sırasında ateş yüksekliğinin kısmen gerilediği gözlenmiş ancak lökopeniye yol açmış olması nedeni ile devam edilememişti. Anti-TB tedavinin 64, LNZ dokuzuncu gününde ateş yüksekliği devam eden hastaya prednol 60 mg/gün başlandı. Ateş yine devam etmesi üzerine 71. günde CYC ve LNZ kesildi. E 110, moksifloksasin 110, R 80, Z 60 güne tamamlandıktan sonra R ve E ile tedaviye sekiz ay daha devam edildi. Tedavi bitimi sonrası birinci yıl kontrolünde nüks saptanmadı. Sonuç: TB tedavisi sırasında görülen yan etkiler tedavi süresinin uzamasına, hastanın tedavi uyumunun bozulmasına, tedavi başarısızlığına ve nüks oranlarında artmaya neden olabilir. Hasta olası yan etkiler açısından uyarılmalı, yakın takibi yapılmalıdır. TB tedavisinde yeterli bir tedavi rejiminin sürekli olması ve tedavi süresinin de ilaç rejimine göre belirlenmesi gerekir. [ABSTRACT FROM AUTHOR]

Copyright of Mediterranean Journal of Infection, Microbes & Antimicrobials is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Mediterranean Journal of Infection, Microbes & Antimicrobials is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Mediterranean Journal of Infection, Microbes & Antimicrobials is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Mediterranean Journal of Infection, Microbes & Antimicrobials is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Mediterranean Journal of Infection, Microbes & Antimicrobials is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Mediterranean Journal of Infection, Microbes & Antimicrobials is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Mediterranean Journal of Infection, Microbes & Antimicrobials is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Mediterranean Journal of Infection, Microbes & Antimicrobials is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Mediterranean Journal of Infection, Microbes & Antimicrobials is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Mediterranean Journal of Infection, Microbes & Antimicrobials is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Mediterranean Journal of Infection, Microbes & Antimicrobials is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)