Wos İndeksli Yayınlar Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/11727/4807
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Item Efficacy and Cost-Effectivity Analysis of Outpatient Parenteral Antimicrobial Therapy Unit in Infectious Disease Clinical Practices: Turkey Perspective(2021) Bastug, Aliye; Oksuz, Ergun; Kazancioglu, Sumeyye; Malhan, Simten; Ozbay, Bahadir Orkun; Bodur, Hurrem; 0000-0002-5723-5965; 33709495; K-8238-2012Background Outpatient parenteral antimicrobial treatment (OPAT) has become a common treatment modality in developed countries. OPAT units are not widespread in Turkey, and their cost-effectivity analysis has not been studied, yet. Aims To analyze the clinical efficacy and cost-effectiveness of the OPAT unit, based on a 1000-bed teaching hospital. Methods The records of patients, who were treated between October 2013 and December 2017, in an OPAT unit of a tertiary hospital in Ankara, were obtained retrospectively. The cost that would arise if the patients were hospitalized for the same treatment period with the same diagnosis was calculated and compared with the actual treatment cost of the patients in the OPAT unit. Results A total of 594 patients who received antimicrobial treatment at the OPAT unit were enrolled. The mean age of the patients was 55.39 +/- 16.37 years and 313 (52.7%) were males. Based on the end-of-treatment goals, 98.5% of the patients reached the treatment goal. An indirect cost analysis revealed that the OPAT unit was 487.625 94 TL/129.008 78 $ less costly than inpatient parenteral antibiotic treatment. In other words, OPAT cost was 75% of the equivalent inpatient costs. It was also determined that a total of 7078 bed days and 11.9 bed days per person were saved. Conclusions OPAT units should be expanded increasingly in Turkey. The evaluation together with the health care system conditions in Turkey revealed that the OPAT program is safe, effective, and cost-efficient.Item Safe and Effective Use of Venlafaxine, Mirtazapine, and Aripiprazole in an Adolescent with Treatment-Resistant Obsessive Compulsive Disorder(2020) Aksu, Gulen Guler; Dogdu, Pinar Akdere; Dag, Pelin; Kutuk, Meryem Ozlem; Toros, Fevziye; 0000-0002-2918-7871; AAI-9626-2021Managing treatment-resistant obsessive-compulsive disorder (TR-OCD) is often a challenge for clinicians, especially when adolescents and children are the patients. Approximately one-quarter to one-third of children with OCD do not respond to first-line treatments. Studies on the combination of venlafaxine and mirtazapine in children and adolescents are promising, but there is insufficient information about the use of this combination in TR-OCD. As far as we know, this is the first report of an adolescent patient with TR-OCD who responded favorably to a combination of a serotonin-norepinephrine reuptake inhibitor (venlafaxine), an alpha-2 adrenergic receptor antagonist (mirtazapine), and an atypical antipsychotic (aripiprazole). This case provides an example of the effective and safe use of the venlafaxine, mirtazapine, and aripiprazole given in combination in an adolescent with TR-OCD.