Journal of Literature Pharmacy Sciences

.: REVIEW
Eczacının Yer Aldığı Antimikrobiyal Yönetim Programlarının Klinik ve Ekonomik Sonuçları
The Clinical and Economic Outcomes of the Pharmacist Involved-Antimicrobial Stewardship Programs
Mesut SANCARa, Zeynep ÜNAL SAYINa, Sercan CANKATARa, Nazan DALGIÇb, Betül OKUYANa
aKlinik Eczacılık AD, Marmara Üniversitesi Eczacılık Fakültesi,
bÇocuk Enfeksiyon Hastalıkları Kliniği, Sağlık Bilimleri Üniversitesi Şişli Hamidiye Etfal Eğitim ve Araştırma Hastanesi, İstanbul, TÜRKİYE
J Lit Pharm Sci. 2019;8(1):18-28
doi: 10.5336/pharmsci.2018-62144
Article Language: TR
Full Text
ÖZET
 Antimikrobiyal yönetim programı, antimikrobiyal ilaç tedavisinin iyileştirilmesine yönelik düzenlemeleri kapsayan, multidisipliner bir yaklaşımdır. Son yıllarda, özellikle antibiyotik direncinin azaltılmasında önemli yeri olduğu kabul edilen antimikrobiyal yönetim programlarında öncelikle doktor, klinik eczacı ve klinik mikrobiyologlardan oluşan bir ekibe yer verilmesi önerilmektedir. Eczacının, antimikrobiyallerin uygulama zamanı ve veriliş sıklığı konusundaki danışmanlığının yanı sıra, bu ilaçlara bağlı ilaç-ilaç, ilaç-besin ve ilaç-hastalık etkileşimleri, ilaç istenmeyen etkileri gibi alanlarda da katkı yapabilecekleri bilinmektedir. Bu çalışmada, enfeksiyon hastalıklarının kontrolünde ve tedavisinde önemli yeri olan antimikrobiyal yönetim programlarında sağlık ekibinin önemli bir parçası olarak bulunan eczacıların olası etkilerinin klinik ve ekonomik boyutlarının irdelenmesi amaçlanmıştır. Bu amaca yönelik olarak, Pubmed veri tabanında 01.01.2010 - 31.12.2015 yıllarını kapsayan 5 yıllık bir literatür taraması yapılmıştır. Uygun sözcükler kullanılarak doğrudan eczacı katkısını araştıran çalışmalar seçilmiştir. Bu çalışmanın amacına uygun olarak 34 orijinal makale incelenmiştir. Bu çalışmalarda, eczacı müdahalelerinin yer aldığı antimikrobiyal yönetim programlarının pozitif klinik ve ekonomik sonuçları olduğu görülmüştür. Eczacının bu yönetim programlarında antimikrobiyallerin daha akılcı kullanılmasına, antibiyotiklerin daha az sayıda reçete edilmesine, direnç oranlarının azaltılmasına, daha fazla klinik değerlendirme yapılmasına, ilaç dozunun ayarlanmasına, antimikrobiyal ilacın kesilmesi veya başlanması süreçlerine, parenteral kullanımdan oral kullanıma geçiş oranlarının artırılmasına ve nihai olarak bakım kalitesinin iyileştirilmesine fayda sağladıkları sonucuna varılmıştır. Ülkemizde klinik eczacılık uzmanlık eğitiminin başlamış olması, meslek içi eğitim programlarının artırılması ve klinik eczacılık lisansüstü programlarının yaygınlaştırılması, eczacının bu çalışmada adı geçen görevleri yerine getirebilmesi için önemli fırsatlardır.

Anahtar Kelimeler: Antimikrobiyal yönetim programı; eczacı; klinik sonuçlar; ekonomi
ABSTRACT
 The antimicrobial stewardship program is a multidisciplinary approach that involves regulations to improve antimicrobial drug therapy. It is primarily suggested that a team consisting of physicians, clinical pharmacists and clinical microbiologists should be included in antimicrobial stewardship programs, which are considered to have an important role in reducing antibiotic resistance in recent years. It is known that the pharmacist may contribute to the time and frequency of administration of antimicrobials, as well as in the fields of drug-drug, drug-food and drug-disease interaction and drug adverse effects. The aim in this review is to examine the clinical and economic outcomes of the pharmacists, WHO have known as an essential member of healthcare team, involvement in antimicrobial stewardship programs which have important impact on the control and treatment of infectious diseases in recent years. A literature review covering the last 5 years (01.01.2010-31.12.2015) was made on the Pubmed database for this purpose. Studies which had shown direct pharmacist intervention, were selected by using appropriate words. For the purpose of this review, 34 original articles have been examined. It was concluded that the pharmacists in these programs provide benefits on more rationale usage of antimicrobials, fewer prescriptions of antibiotics, lower resistance rates, more application of clinical evaluation, the adjustment of drug dosage, the process of antimicrobial drug withdrawal or initiation, increased rate of change form parenteral to oral route and ultimately improved quality of care. As a result of the development of clinical pharmacy specialization training in our country, increase in inter-professional training programs and dissemination of clinical pharmacy post-graduate programs are important opportunities for the pharmacists to fulfill their duties mentioned in this review.

Keywords: Antimicrobial stewardship; pharmacist; clinical outcomes; economics
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-To determine the tendency of the visitors on using our website

-To send print publications/correspondences

-To send press releases or notifications through e-mail

-To generate a list for an event or competition

By using www.turkiyeklinikleri.com you are considered to agree that;

-Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. cannot be hold responsible for any user’s illegal and immoral behavior,

-Terms of use may change from time to time,

-It is not responsible for other websites’ contents it cannot control or the harms they may cause although it uses the connection they provided.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. may block the website to users in the following events:

-Information with wrong, incomplete, deceiving or immoral expressions is recorded to the website,

-Proclamation, advertisement, announcement, libelous expressions are used against natural person or legal identity,

-During various attacks to the website,

-Disruption of the website because of a virus.

Written, visual and audible materials of the website, including the code and the software are under protection by legal legislation.

Without the written consent of Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. the information on the website cannot be downloaded, changed, reproduced, copied, republished, posted or distributed.

All rights of the software and the design of the website belong to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. will be pleased to hear your comments about our terms of use. Please share the subjects you think may enrich our website or if there is any problem regarding our website.

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