Upravljanje antimikrobnom terapijom i antimikrobna rezistencija u doba COVID-19 pandemije

professional thesis

• Author: Marija Špelić
• Mentor: Vladimir Krajinović (mentor)
• Committee member: Maja Šegvić Klarić (predsjednik povjerenstva)
• Committee member: Vladimir Krajinović (član povjerenstva)
• Committee member: Marija Santini (član povjerenstva)
• Granter: University of Zagreb; Faculty of Pharmacy and Biochemistry; Zagreb
• Defense date and country: 2023-09-05, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Pharmacy; Pharmacy

Abstract

Bolest uzrokovana koronavirusom SARS-CoV-2 (COVID-19) koja se prvi put službeno
pojavila u Kini u prosincu 2019. godine, vrlo se brzo proširila diljem svijeta i bila u fokusu
zdravstvenih sustava. Unatoč pandemiji, antimikrobna rezistencija bila je i ostala gorući
globalni zdravstveni problem koji se ne smije zanemariti. Antimikrobna rezistencija jedan je od
najvećih izazova s kojima se susreće moderna medicina, posebice u novonastalim okolnostima
pandemije. Postoje brojni čimbenici koji utječu na rezistenciju, a neki su promijenjeni u vrijeme
pandemije. Povećana je higijena ruku i postupci prevencije infekcija, smanjena su međunarodna
putovanja i reduciran je broj rutinskih bolničkih postupaka. Iako je COVID-19 virusna bolest,
rano u tijeku pandemije zamijećena je prekomjerna potrošnja antibiotika zbog ambulantne i
bolničke primjene ovih lijekova. Od ranije je poznato da prekomjerna primjena antibiotika
potiče razvoj rezistencije bakterija na antibiotike. Činjenica je da manje od 8 % bolesnika s
COVID-19 bolesti zaista ima bakterijsku koinfekciju koja nastaje rano u tijeku bolesti, a puno
više bolesnika je nepotrebno primalo antibiotike. Prema svim smjernicama primjena antibiotika
ne preporučuje se ukoliko ne postoji bakterijska koinfekcija, osobito ako se radi o blagom
obliku bolesti COVID-19. Zbog svega navedenoga potrebno je revidirati programe upravljanja
antimikrobnom terapijom, prilagoditi ih aktualnoj, pandemijskoj situaciji i koristiti u praksi.
Takvi su se programi već pokazali učinkovitima u smanjenju potrošnje antibiotika i smanjenju
rezistencija bakterija, a mogu doprinijeti poboljšanju ishoda bolesnika i smanjenju troškova u
zdravstvu.

Abstract (english)

The disease caused by the SARS-CoV-2 (COVID-19) coronavirus, which first officially
appeared in China in December 2019, spread very quickly around the world and was the focus
of health systems. Despite the pandemic, antimicrobial resistance remained a pressing global
health problem that should not be ignored. Antimicrobial resistance is one of the biggest
challenges facing modern medicine, especially in the newly emerging circumstances of a
pandemic. There are many factors that influence resistance, some of which have changed during
the pandemic. Hand hygiene and infection prevention procedures have been increased,
international travel has been reduced and the number of routine hospital procedures has been
reduced. Although COVID-19 is a viral disease, excessive consumption of antibiotics due to
outpatient and hospital use of these drugs was observed early in the pandemic. It has long been
known that the excessive use of antibiotics promotes the development of bacterial resistance to
antibiotics. The fact is that less than 8% of patients with COVID-19 actually have a bacterial
co-infection that occurs early in the course of the disease, but many patients received antibiotics
unnecessarily. According to all guidelines, the use of antibiotics is not recommended unless
there is a bacterial co-infection, especially if it is a mild form of the disease of COVID-19.
Because of all of the above, it is necessary to revise antimicrobial therapy management
programs, adapt them to the current, pandemic situation and use them in practice. Such
programs have already proven to be effective in reducing antibiotic consumption and bacterial
resistance, and can contribute to improving patient outcomes and reducing healthcare costs.

• Keywords: antimikrobna rezistencija; bakterijske koinfekcije; COVID-19; SARS-CoV-2; sekundarne infekcije; upravljanje antimikrobnom terapijom
• Keywords (english): antimicrobial resistance; antimicrobial stewardship; bacterial coinfection; COVID19; SARS-CoV-2; secondary infections
• Language: croatian
• URN:NBN: urn:nbn:hr:163:459740
• Study programme: Title: Clinical pharmacy; Study programme type: university; Study level: postgraduate specialist; Academic / professional title: sveučilišni/a magistar/sveučilišna magistra kliničke farmacije (sveučilišni/a magistar/sveučilišna magistra kliničke farmacije)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2024-05-17 11:27:18