{"id":34498,"date":"2024-11-26T16:39:19","date_gmt":"2024-11-26T16:39:19","guid":{"rendered":"https:\/\/bnssghealthiertogether.org.uk\/?page_id=34498"},"modified":"2025-01-16T21:51:35","modified_gmt":"2025-01-16T21:51:35","slug":"improving-primary-care-antibiotic-prescribing-to-reduce-antibiotic-resistant-urine-infections-the-ipap-uti-programme","status":"publish","type":"page","link":"https:\/\/bnssghealthiertogether.org.uk\/tr\/integrated-care-board\/research-and-evidence\/our-research-portfolio\/nihr-funded-projects\/improving-primary-care-antibiotic-prescribing-to-reduce-antibiotic-resistant-urine-infections-the-ipap-uti-programme\/","title":{"rendered":"Birinci basamak sa\u011fl\u0131k hizmetlerinde antibiyotik re\u00e7eteleme uygulamalar\u0131n\u0131 iyile\u015ftirerek antibiyotik diren\u00e7li idrar yolu enfeksiyonlar\u0131n\u0131 azaltmak: IPAP-UTI program\u0131"},"content":{"rendered":"<div class=\"assembler_default-group assembler_module_group assembler_default-group_1 assembler_module_group_1\"><div class=\"assembler_module_area assembler_module_area_1\"><div class=\"assembler_text-module assembler_module assembler_text-module_1 assembler_module_1  transparent\"><a tabindex=\"-1\" title=\"Mod\u00fcl-1 ba\u015fl\u0131kl\u0131 b\u00f6l\u00fcm\" id=\"module-1\" href=\"https:\/\/bnssghealthiertogether.org.uk\/tr\/wp-json\/wp\/v2\/pages\/34498\/#module-1\" class=\"anchor\"><span class=\"hidden\">Mod\u00fcl-1 ba\u015fl\u0131kl\u0131 b\u00f6l\u00fcm<\/span><\/a><!-- Template found for text-module - Template: template-text - Matched: _only --><section class=\"w-full mx-auto max-w-content pt-12 sm:pt-24 pb-12 sm:pb-24\">\r\n  <div class=\"entry-content w-full !px-0 max-w-small\">\r\n        <h1>Birinci basamak sa\u011fl\u0131k hizmetlerinde antibiyotik re\u00e7eteleme uygulamalar\u0131n\u0131 iyile\u015ftirerek antibiyotik diren\u00e7li idrar yolu enfeksiyonlar\u0131n\u0131 azaltmak: IPAP-UTI program\u0131.<\/h1>\n<article class=\"page_content\">\n<h2><\/h2>\n<h2 class=\"page_content__inner\">Finansman<\/h2>\n<\/article>\n<p>Ulusal Sa\u011fl\u0131k ve Bak\u0131m Ara\u015ft\u0131rma Enstit\u00fcs\u00fc (NIHR) Uygulamal\u0131 Ara\u015ft\u0131rma Program\u0131 Hibeleri (PGfAR) Ref. NIHR204400.<\/p>\n<h2>Sorun nedir?<\/h2>\n<p>Antibiyotik direnci (AMR) sa\u011fl\u0131k i\u00e7in ciddi bir tehdittir. E\u011fer bir \u015fey yapmazsak, bakteriler giderek daha fazla antibiyoti\u011fe kar\u015f\u0131 diren\u00e7 kazanacak ve enfeksiyonlar tedavi edilemez hale gelecektir. Baz\u0131 bilim insanlar\u0131, 2050 y\u0131l\u0131na kadar AMR enfeksiyonlar\u0131ndan \u00f6len insan say\u0131s\u0131n\u0131n kanserden \u00f6len insan say\u0131s\u0131ndan daha fazla olaca\u011f\u0131n\u0131 tahmin ediyor.<\/p>\n<p>\u0130drar yolu enfeksiyonlar\u0131, NHS&#039;de (\u0130ngiliz Ulusal Sa\u011fl\u0131k Sistemi) tedavi edilen en yayg\u0131n bakteriyel enfeksiyondur ve \u00e7o\u011funlukla birinci basamak sa\u011fl\u0131k hizmetlerinde pratisyen hekimler (GP&#039;ler) ve hem\u015fireler taraf\u0131ndan re\u00e7ete edilen antibiyotikler kullan\u0131larak tedavi edilir.<\/p>\n<p>\u0130drar yolu enfeksiyonlar\u0131na neden olan bakterilerin 1&#039;e kadar\u0131 en az bir antibiyoti\u011fe diren\u00e7lidir; bu da antibiyoti\u011fin art\u0131k etkili bir tedavi olmad\u0131\u011f\u0131 anlam\u0131na gelir. Bu durum, insanlar\u0131n daha uzun s\u00fcren, daha \u015fiddetli enfeksiyonlar ge\u00e7irebilece\u011fi ve daha fazla antibiyotik k\u00fcr\u00fcne ihtiya\u00e7 duyabilece\u011fi anlam\u0131na gelir.<\/p>\n<p>Aile hekimleri ve hem\u015fireler, idrar yolu enfeksiyonlar\u0131 i\u00e7in \u00f6nerilen ilk tercih antibiyotikler olan trimetoprim yerine nitrofurantoin re\u00e7ete etmeye te\u015fvik edildi. Baz\u0131 \u00e7al\u0131\u015fmalar bunun trimetoprim antibiyotik direnci oranlar\u0131n\u0131 d\u00fc\u015f\u00fcrd\u00fc\u011f\u00fcn\u00fc, ancak di\u011fer antibiyotikler i\u00e7in daha y\u00fcksek antibiyotik direnci oranlar\u0131na yol a\u00e7m\u0131\u015f olabilece\u011fini \u00f6ne s\u00fcr\u00fcyor.<\/p>\n<p>Bu sonu\u00e7lar, politika yap\u0131c\u0131lar\u0131 iki soru sormaya y\u00f6neltiyor. Birincisi: &#039;Bu sonu\u00e7lar g\u00fcvenilir mi?&#039; ve ikincisi: &#039;Ne yap\u0131lmal\u0131?&#039;\u2018<\/p>\n<p>Buna kar\u015f\u0131l\u0131k, kullan\u0131lan y\u00f6ntemler de\u011fi\u015fikliklerin ba\u015fka nedenleri olabilece\u011fi anlam\u0131na geldi\u011finden ve bundan sonra ne yap\u0131laca\u011f\u0131 bilinmedi\u011finden veriler g\u00fcvenilir de\u011fil. Fikirler var, ancak faydalar\u0131n zararlardan daha fazla olup olmad\u0131\u011f\u0131n\u0131 bilmiyoruz.<\/p>\n<h2>Ara\u015ft\u0131rman\u0131n amac\u0131 nedir?<\/h2>\n<p>Amac\u0131m\u0131z, birinci basamak sa\u011fl\u0131k hizmetlerinde idrar yolu enfeksiyonlar\u0131n\u0131 (\u0130YE) tedavi etmek i\u00e7in doktorlar\u0131n en iyi antibiyoti\u011fi se\u00e7melerine yard\u0131mc\u0131 olacak g\u00fcvenilir kan\u0131tlar olu\u015fturmak ve antibiyotik (antimikrobiyal) direncini (AMR) azaltmakt\u0131r.<\/p>\n<h2>Bu nas\u0131l ba\u015far\u0131lacak?<\/h2>\n<p>Rastgele kontroll\u00fc \u00e7al\u0131\u015fma (RCT), ila\u00e7 etkinli\u011fini ara\u015ft\u0131rman\u0131n tek g\u00fcvenilir y\u00f6ntemidir. Bu program, ciddi antimikrobiyal diren\u00e7 sorunlar\u0131n\u0131n oldu\u011fu b\u00f6lgelerde ve en \u00e7ok etkilenen gruplarda y\u00fcr\u00fct\u00fclecek \u00fc\u00e7 RCT&#039;yi i\u00e7erecektir. Irk, ya\u015f veya mali durumun sonu\u00e7lar\u0131 etkileyip etkilemedi\u011fi rapor edilecektir.<\/p>\n<p>Baz\u0131 pratisyen hekim muayenehaneleri alternatif bir antibiyotik kullanmaya (veya iki antibiyoti\u011fi d\u00f6n\u00fc\u015f\u00fcml\u00fc olarak kullanmaya) te\u015fvik edilecek, di\u011ferleri ise ola\u011fan bak\u0131ma devam edecektir. Antibiyotik kullan\u0131m\u0131n\u0131 ve antimikrobiyal diren\u00e7 oranlar\u0131n\u0131 kar\u015f\u0131la\u015ft\u0131raca\u011f\u0131z ve herhangi bir fark\u0131n m\u00fcdahaleden kaynaklanaca\u011f\u0131n\u0131 tahmin ediyoruz.<\/p>\n<h2>Ara\u015ft\u0131rmay\u0131 kim y\u00fcr\u00fct\u00fcyor?<\/h2>\n<p><a href=\"https:\/\/research-information.bris.ac.uk\/en\/persons\/alastair-d-hay\" rel=\"noopener\">Profes\u00f6r Alastair D Hay<\/a>, Bristol \u00dcniversitesi Birinci Basamak Sa\u011fl\u0131k Hizmetleri Profes\u00f6r\u00fc.<\/p>\n<h2>Daha fazla bilgi:<\/h2>\n<p>Daha fazla bilgi almak veya bu projeye kat\u0131lmak i\u00e7in l\u00fctfen e-posta g\u00f6nderin. <a href=\"mailto:bnssg.research@nhs.net\" target=\"_blank\" rel=\"noopener\">bnssg.research@nhs.net<\/a>.<\/p>\n<p>Burada ifade edilen g\u00f6r\u00fc\u015fler yazar(lar)a aittir ve NIHR veya Sa\u011fl\u0131k ve Sosyal Bak\u0131m Bakanl\u0131\u011f\u0131&#039;n\u0131n g\u00f6r\u00fc\u015flerini yans\u0131tmayabilir.<\/p>\n  <\/div>\r\n  <\/section><\/div><!-- .assembler_text-module.assembler_module.assembler_text-module_1.assembler_module_1..transparent --><\/div><!-- .assembler_module_area.assembler_module_area_1 --><\/div><!-- .assembler_default-group.assembler_module_group.assembler_default-group_1.assembler_module_group_1  -->","protected":false},"excerpt":{"rendered":"<p>Section titled module-1 Improving primary care antibiotic prescribing to reduce antibiotic resistant urine infections: the IPAP-UTI programme. Funding National Institute for Health and Care Research (NIHR) Programme Grants for Applied Research (PGfAR) Ref. NIHR204400. What is the problem? AMR is a serious threat to health. Unless we do something, bacteria will become resistant to more [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":32881,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"tags":[],"class_list":["post-34498","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/bnssghealthiertogether.org.uk\/tr\/wp-json\/wp\/v2\/pages\/34498","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/bnssghealthiertogether.org.uk\/tr\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/bnssghealthiertogether.org.uk\/tr\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/bnssghealthiertogether.org.uk\/tr\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/bnssghealthiertogether.org.uk\/tr\/wp-json\/wp\/v2\/comments?post=34498"}],"version-history":[{"count":3,"href":"https:\/\/bnssghealthiertogether.org.uk\/tr\/wp-json\/wp\/v2\/pages\/34498\/revisions"}],"predecessor-version":[{"id":36160,"href":"https:\/\/bnssghealthiertogether.org.uk\/tr\/wp-json\/wp\/v2\/pages\/34498\/revisions\/36160"}],"up":[{"embeddable":true,"href":"https:\/\/bnssghealthiertogether.org.uk\/tr\/wp-json\/wp\/v2\/pages\/32881"}],"wp:attachment":[{"href":"https:\/\/bnssghealthiertogether.org.uk\/tr\/wp-json\/wp\/v2\/media?parent=34498"}],"wp:term":[{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/bnssghealthiertogether.org.uk\/tr\/wp-json\/wp\/v2\/tags?post=34498"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}