Neracionalus antimikrobinių vaistų (AMV) vartojimas didina mikroorganizmų atsparumą, gydymo kaštus ir hospitalizacijos trukmę. Didėjantis atsparumas AMV yra svarbi visuomenės sveikatos problema. Magistro darbo tikslas - kokybiškai ir kiekybiškai įvertinti AMV skyrimo KMU klinikose paplitimą bei jo pokyčius ir atitikimo racionalaus AMV vartojimo rekomendacijoms ypatumus ir dėsningumus. Tyrimas atliktas naudojant „skersinio pjūvio“ metodiką. 2007 m. kovo mėnesį vienmomentinio apžvalginio tyrimo metu (2 savaičių laikotarpyje) atrinktos ir išanalizuotos pacientų, kurie gauna AMV, ligos istorijos ir paskyrimai 32-iuose KMU klinikų skyriuose. AMV vartojimas yra racionalus, jei jų skyrimas atitinka racionalaus AMV vartojimo rekomendacijoms. Peržiūrėta 1213 paskyrimų, AMV buvo skirti 265 pacientams. Rekomendacijų neatitiko pusė (54 proc.) visų AMV paskyrimų. Daugiau kaip pusė (58 proc.) gydymo tikslu skirtų empirinių AMV paskyrimų vertinti kaip neatitinkantys racionalaus AMV rekomendacijų. Vertinant AMV skyrimo atitikimą rekomendacijoms atskiruose skirtingo profilio skyriuose daugiausia neatitikusių paskyrimų nustatyta chirurginio (74 proc.) ir terapinio (55 proc.) profilio skyriuose, atitikusių – pediatrinio (71proc.) ir intensyvios terapijos (60 proc.) profilių skyriuose. Ryšio tarp skyriaus profilio ir atitikimo rekomendacijoms nenustatyta. (r = 0,5387 , p = 0,4613, Spearmano koreliacija). Didžiąją dalį neatitinkančių rekomendacijų paskyrimų atvejų (56,86 proc.) sudarė... [toliau žr. visą tekstą] / Irrational and excessive use of antibiotics increases resistance to these preparations. Antimicrobial resistance is a serious public health problem worldwide. The main goal of our study was to evaluate and to compare the non-adherence (NA) to guidelines (NfG) on rational antibiotic therapy and prophylaxis (ABT/P) in tertiary hospital setting among two years (2006 and 2007). A cross-sectional study was performed in order to collect the data for patients receiving prescriptions for antimicrobial agents in March, 2007. Descriptive and comparative data were processed and evaluated using Graph Pad Prism 4 statistics program. Rationality of antibiotic therapy was evaluated according for adherence to published guidelines. A total of 265 (21%) patients recieved antibiotic therapy. 54% of all events were considered as non-adherent.The majority of NA cases was determined in the departments of therapeutic profile (55%) and in surgical profile (74%). The adherent events - in paediatric profile(71%) and in the intensive therapy profile (60%). No dependence between the type of profile and adherence to guidelines was determined (r = 0,5387, p = 0,4613, Spearman correlation). The main reasons of NA were inapropriate dosage (57%) and choice of drug (43% ). NA case analysis revealed too high dose prescribed in 40/87 (46%) cases, too low dose 47/87 (54%)cases; too broad spectrum in 28/61 (46%) cases, too narrow - in 9/61(15%), 2/61 ( 3 %) case as unsafe and 22/61 (36%) cases... [to full text]

In our study we analyzed pathogenic microorganisms from burn wounds, their rate and changes after tightening the infection control. Special attention was paid to the diagnostics and treatment problems of Staphylococcus aureus. We have been studying Rational application algorithm of antibacterial drugs influence on the effectiveness of the infection diagnostics and treatment, and the changes of Staphylococcus aureus resistance to antibiotics. There was performed an experimental analysis of pathogenic microorganisms with „electronic nose“ and a comparison was made of changing parameters in „electronic nose“ resistance studying Acinetobacter spp., Escherichia coli, Pseudomonas aeruginosa, Staphylococus aureus pathogenic microorganisms. This experiment underlies further investigations of the early diagnostics of the pathogenic microorganisms. Our research works have characterized it from the complex standpoint to the solution of burn wound infection prevention, diagnostics, and treatment problems what is missing in analyzed literature.