Faktori koji utiču na cenu antibiotske terapije i ishod kod kritično obolelih pacijenata: “real-life” studija

  • Aneta Perić Sector for Pharmacy, Military Medical Academy, Belgrade, Serbia; Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
  • Maja Šurbatović Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia; Clinic of Anesthesiology and Intensive Therapy, Military Medical Academy, Belgrade, Serbia
  • Sandra Vezmar Kovačević Department of Pharmacokinetics and Clinical Pharmacy, Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia
  • Mirjana Antunović Sector for Pharmacy, Military Medical Academy, Belgrade, Serbia; Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
  • Milić Veljović Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia; Clinic of Anesthesiology and Intensive Therapy, Military Medical Academy, Belgrade, Serbia
  • Dragan Djordjević Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia; Clinic of Anesthesiology and Intensive Therapy, Military Medical Academy, Belgrade, Serbia
  • Tamara Andjelić Institute of Medical Biochemistry, Military Medical Academy, Belgrade, Serbia
  • Snježana Zeba Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia; Clinic of Anesthesiology and Intensive Therapy, Military Medical Academy, Belgrade, Serbia
  • Silva Dobrić Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia; Institute for Scientific Information, Military Medical Academy, Belgrade, Serbia
DOI: https://doi.org/10.2298/4834
Ključne reči: critical illness||, ||kritična stanja, sepsis||, ||sepsa, anti-bacterial agents||, ||antibiotici, cost and cost analysis||, ||cene i analize cena, biological markers||, ||biološki pokazatelji,

Sažetak


Uvod/Cilj. Kritično oboleli pacijenti imaju veliki rizik od razvoja teških infekcija u jedinicama intenzivne terapije (JIT). Nivo prokalcitonina (PCT) u cirkulaciji je povišen kod bolesnika sa bakterijskom sepsom, tako da PCT može biti koristan u praćenju antibiotske terapije. Cilj ove studije bio je da se ustanove faktori koji utiču na ishod i troškove lečenja u JIT u našoj ustanovi sa posebnim naglaskom na uticaj korišćenja serumskog nivoa PCT u vođenju antimikrobne terapije. Metode. Studija je sprovedena od avgusta 2010. godine do maja 2012. godine u Jedinici intenzivne terapije Klinike za anesteziologiju i intenzivnu terapiju Vojnomedicinske akademije (VMA) u Beogradu, Srbija. Svi kritično oboleli sa sepsom i/ili traumom koji su primljeni u JIT bili su uključeni u studiju. Studijom su obuhvaćeni samo troškovi antimikrobne terapije u JIT i troškovi PCT analize. Koristili smo cenovnik VMA za 2012. godinu. PCT u serumu je meren tehnikom homogenog imunoeseja na Brams Kriptor analizatoru. Rezultati. Studijom su bila obuhvaćena 102 bolesnika. Prosečna starost bolesnika iznosila je 55 ± 19 godina, a 61,8% bolesnika bili su muškarci. Prosečna dužina boravka u JIT (lenght of stay – LOS) iznosila je 12 ± 21 dana. Postojala je statistički značajna razlika (p < 0.001) između ishoda lečenja u grupi sa sepsom u odnosu na grupu sa traumom. Bolesnici mlađi od 70 godina imali su bolju šansu da prežive. Dužina boravka, upotreba karbapenema i merenje PCT uticali su na cenu terapije u JIT. Zaključak. Dobijeni rezultati pokazuju da su godine života, dijagnoza i pol bili glavni prediktori preživljavanja kritično obolelih u JIT. Cena terapije zavisila je od dužine boravka u JIT, upotrebe karbapenema i merenja PCT, ali uticaj ovih faktora na ishod lečenja nije dostigao statističku značajnost.

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Objavljeno
2015/04/24
Broj časopisa
Vol. 71 Br. 12 (2014)
Rubrika
Originalni članak