KAFA TABANI OSTEOMYELİTİ OLAN HASTALARDA ANTİMİKROBİYAL TEDAVİYİ ETKİLEYEN FAKTÖRLER

Abstract

ABSTRACT AHMADOVA F. FACTORS AFFECTING ANTIMICROBIAL THERAPY IN PATIENTS DIAGNOSED WITH SKULL BASE OSTEOMYELITIS. HACETTEPE UNİVERSİTY FACULTY OF MEDİCİNE, DEPARTMENT OF INFECTİOUS DİSEASES AND CLİNİCAL MİCROBİOLOGY SPECİALİZATİON THESİS. ANKARA, 2023. In our study, the files of 545 patients who were diagnosed with osteomyelitis (ICD code M86) by applying to the Infectious Diseases and Clinical Microbiology and Ear, Nose and Throat Diseases Departments between 2012-2021 were examined. Among these, 43 patients with a diagnosis of CTO and for whom sufficient data could be obtained were included in the study. Presence of radiological or clinical improvement in the patients examined was chosen as the criterion. Patients were classified into 3 groups as regression, stable and progression; demographic information in these groups, accompanying signs and diseases that may pose a risk factor for the diagnosis of CTO, symptoms and signs present at the time of diagnosis, methods applied for the diagnosis of the disease, methods used in the follow-up of the disease, whether surgical debridement is performed as a treatment method, duration of antibiotic treatment, cranial nerve Complications related to the disease, especially paralysis, and mortality results were compared. Eight (18.6%) of the study patients were female and 35 (81.4%) were male, (external otitis media, otitis media, cholesteatoma) in 38 patients (88.4%), type 2 diabetes mellitus in 31 patients (72.1%), hypertension in 27 patients (62.8%), 19 patients (44%) ,2) heart failure, 13 patients (30.2%) chronic kidney damage, 11 patients (25.6%) malignancy, 7 (16.3%) pulmonary disease, and 5 patients (11.6%) immunodeficiency. . The most common symptom was headache in 41 (95.3%) patients, and earache in 40 (93.0%) patients. When the predisposing factors were evaluated in patients with CTO, autogenic causes were found in 19 (44.2%) patients and non-autogenic causes were found in 12 (27.9%) patients. The duration of treatment was less than one month in 11.8% of the regression group, 16.7% of the stable group, and 50.0% of the progression group, and there was a statistically significant difference between the groups (p<0.05). The average of IV antibiotic use was highest in the v regression group, followed by the stable and progression groups, respectively. Oral antibiotic use was highest in the stable group, followed by regression and progression groups, respectively. Total antibiotic use was highest in the regression group, followed by the stable and progression groups, respectively. According to the results of the difference analysis, the differences between the three groups in IV, oral and total antibiotic use were not statistically significant (p>0.05). Although antibiotic therapy is the major treatment for all patients, the surgical combination is predominant. IV antibiotics seem to be more effective or used in severe clinical situations.