BOLALARDA NAFAS YO‘LLARI INFEKSIYALARIDA ORTIQCHA ANTIBIOTIK QO‘LLASHNI KAMAYTIRISH
Keywords:
antibiotik rezistentligi, bolalar, nafas yo‘llari infeksiyalari, antibiotik stewardship, klinik qaror qabul qilish tizimi, o‘tkir rinofaringit, virus infeksiyasi.Abstract
Ushbu tadqiqot bolalarda nafas yo‘llari infeksiyalarida antibiotiklar noo‘rin qo‘llanilishining tarqalishini aniqlash va antibiotik stewardship strategiyalarining O‘zbekiston sharoitidagi samaradorligini baholash maqsadida o‘tkazildi. Tadqiqotga 1–14 yoshdagi 340 nafar bola jalb etildi. Virus etiologiyali yuqori nafas yo‘llari infeksiyasi bilan murojaat qilgan bemorlarning 67,4 foiziga antibiotiklar asossiz buyurilganligi aniqlandi. Noo‘rin buyurishning asosiy omillari sifatida ota-onalar bosimi (OR=3,41), shifokorlarning yetarli o‘qitilmaganligi (OR=2,87), tezkor laboratoriya tahlillarining yo‘qligi (OR=2,14) va bemorning 3 yoshdan kichik bo‘lishi (OR=1,93) aniqlandi. Klinik qaror qabul qilish yordamchi tizimi (CDSS), shifokorlarni o‘qitish va ota-onalarni axborotlash dasturlarini birgalikda joriy etish noo‘rin antibiotik buyurilishini 67,4 foizdan 29,1 foizga tushirdi (p<0,001; OR=0,21; 95% CI: 0,13–0,34). Antibiotik buyurilmagan bemorlar orasida bakterial asorat chastotasi nazorat guruhi bilan taqqoslaganda farq ko‘rsatmadi (p=0,41), bu esa taktikaning klinik xavfsizligini tasdiqladi. Natijalar antibiotik stewardship dasturlarini bolalar tibbiy muassasalari amaliyotiga keng joriy etish zarurligini asoslaydi.
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