بررسي الگوي مصرف آنتي‌بيوتيك در گاستروآنتريت‌هاي غير باكتريايي در بيماران بستري در بيمارستان شهيد مطهري اروميه: يك مطالعه مقطعي توصيفي

EVALUATION OF ANTIBIOTIC UTILIZATION PATTERN FOR NON-BACTERIAL GASTROENTERITIS IN PATIENTS HOSPITALIZED AT MOTAHARI HOSPITAL: A DESCRIPTIVE CROSS-SECTIONAL STUDY

پيش‌زمينه و هدف: اسهال يكي از مهم‌ترين معضلات بهداشتي كشورهاي درحال‌توسعه است.. شايع‌ترين علت گاستروانتريت در كودكان عفونت‌هاي ويروسي مي‌باشد كه نياز به تجويز آنتي‌بيوتيك ندارد و مقاومت به آنتي‌بيوتيك يكي از مهم‌ترين مشكلات پزشكي در چند دهه اخير مي‌باشد لذا اين مطالعه جهت بررسي الگوي مصرف آنتي‌بيوتيك در گاستروآنتريت‌هاي غير باكتريايي در بيماران بستري در بيمارستان. شهيد مطهري اروميه صورت گرفت. مواد و روش كار: در اين مطالعه مقطعي توصيفي، پرونده 104 بيمار بستري با گاسترو آنتريت موردبررسي قرار گرفت. و كودكان به سه گروه سني 6 ماه تا 3 سال، 3 سال تا 5 سال و بالاي 5 سال, تقسيم شدند و داده‌هاي مربوط به علائم باليني، مدت اسهال و نتايج آزمايشگاهي ثبت شد و با نرم‌افزار SPSS نسخه 16 مورد تجزيه‌و‌تحليل قرار گرفت. يافته‌ها: در كل نتايج حاصل از بررسي 104 كودك بيمار نشان داد كه بيشترين آنتي‌بيوتيك مصرفي سفترياكسون مي‌باشد (83 نفر,79.8 درصد) و 6 نفر (8/5 درصد) سفتي زوكسيم و 15 نفر (4/14 درصد) هيچ آنتي‌بيوتيكي دريافت نكرده‌اند. و نشان مي‌دهد كه اكثر تجويزهاي آنتي‌بيوتيكي به‌طور بي‌رويه و بدون توجه به نتايج آزمايشگاهي بوده است. بحث و نتيجه‌گيري: با توجه به اينكه اكثر گاستروآنتريت‌ها ويروسي مي‌باشند. لازم است جهت جلوگيري از مقاومت‌هاي ميكروبي در اسهال بر اساس نتايج آزمايشگاهي (كشت و آناليز مدفوع) در موارد مناسب و لازم تجويز گردد.

Background &Aims: Diarrhea is a major health problem in developing countries; and on a global scale, it is the most common cause of death after heart diseases and cancer in many populations. Gastroenteritis is a symptom of the gastrointestinal infection (GI) which is caused by pathogenic bacterial, viral or parasitic infections. In some centers, without complete diagnostic tests to approve bacterial infection, antibiotics are prescribed; and antibiotic therapy is stopped after diagnosing non-bacterial infection. Antibiotics should not be prescribed arbitrarily without medical indications due to complications associated with antibiotic therapy, such as antibiotic-resistant strains that would create problems in the future treatment of diseases resistant to antibiotic treatment. The current study was conducted to investigate the pattern of antibiotic usage for nonbacterial (viral) gastroenteritis in patients hospitalized at Motahari Hospital Materials & Methods: In this retrospective study, all the information was collected from the available medical records in Hospital archives and the results are presented by tables and the average frequency graphs. Children were divided into three age groups (6 months to 3 years - 3 years to 5 years - over 5 years). Data from the medical records of patients including demographic characteristics, duration of diarrhea, fever, clinical symptoms, the results of laboratory tests (analysis, stool cultures, biochemistry, urine analysis) and the antibiotics prescribed in the instructions sheet were all recorded and the related data were analyzed using SPSS. Results: Of 104 patients, 81 patients (77.9%) were six months to three years and 16 patients (15.4%) were three years to five years, and 7 patients (6.7%) were over five years. Sixty patients (57.7%) were males and 44 patients (42.3%) were female. Most patients were male and aged six months to one year (49 patients). Ceftriaxone was the most commonly prescribed antibiotic and 83 patients (79.8%) received it, and 6 patients (5.8%) received ceftizoxime, and 15 patients (14.4) did not receive any antibiotic. The maximum length of hospital stay and antibiotic therapy was 9 days. However, with stool, urine and blood tests being normal, the fever of age groups were 45%, 35%, and 32%, respectively. Conclusion: In order to avoid imposing additional costs and to prevent microbial resistance in diarrhea, it is recommended and urged to prescribe antibiotic for suitable and necessary cases based on laboratory results (culture, stool analysis tests), since the major cause of gastroenteritis is viral infection.