[Evaluation of primary health care physicians' knowledge on rational antibiotic use]. / Saglik ocaklarinda çalisan hekimlerinin akilci antibiyotik kullanimi ile ilgili bilgi düzeylerinin degerlendirilmesi.

Physicians' prescribing practices impact greatly on rational drug use and expenditure. The aim of this cross-sectional study is to determine primary health care physicians' knowledge on rational antibiotic use in Izmir. A total of 475 physicians from primary health care centres (response rate: 100%) participated in this study. Prescription information of physicians was collected with a standardized questionnaire. It was detected that 48.4% of the physicians have prescribed antibiotics in one of each three (30%) prescriptions, while 19.4% in one of each five prescriptions. The most frequent reason for antibiotic prescription was the upper respiratory tract infections (URTI). The rate of prescribing antibiotics for URTI according to the results of throat culture or blood count was 11.8%. The most commonly prescribed antibiotics were penicillins for URTI, quinolones for urinary tract infections and trimethoprim-sulphametoxazole for gastrointestinal tract infections. The rate of appropriate prescribing practices was high among physicians in the age group 25-29 in comparison to older age groups (X2: 14.855; p: 0.01). Only 32.2% of the physicians correctly indicated the antibiotics with drawbacks in newborn period. 6.5% of the participants gave no correct antibiotic choices for any of the infections indicated. It was stated by 89.6% of the participants that they would benefit from continuous education on rational antibiotic use. The data obtained revealed that primary health care physicians who had high antibiotic prescription rates, lacked information about rational antibiotic use and continuous professional education and development programmes related to this topic is a prerequisite.

Pooled analysis of 857 published adult fever of unknown origin cases in Turkey between 1990-2006.

BACKGROUND: The aim of this study was a systematic review of the literature related to adult fever of unknown origin (FUO) in Turkey. MATERIAL/METHODS: To find the published series, three national and two international databases were searched. RESULTS: Data for 857 patients with the diagnosis of fever of unknown origin were obtained from 13 articles. FUO was defined as fever over 38.3 degrees C that continues at least for three weeks with no diagnosis reached after one week of inpatient investigation in all series (Petersdorf and Beason criteria). Infections, collagen vascular diseases, and neoplasms were found to be the reason of fever in 403 (47.0%), 137 (15.9%), and 126 (14.7%) of the in all 857 patients. The most common infectious disease was tuberculosis (147/403, 36.4%) followed by brucellosis (51/403, 12.6%) and infective endocarditis (39/403, 9.6%). The most common collagen vascular disease was adult-onset Still's Disease (49/137, 35.7%), followed by systemic lupus erythematosus (23/137, 16.7%). The most common neoplasms were Hodgkin's disease (32/126, 25.3%) and non-Hodgkin's lymphoma (32/126, 25.3%). The reason of fever could not be defined in 138/857 (16.1%) patients. CONCLUSIONS: Tuberculosis and brucellosis remain common causes of FUO in Turkey. In addition, lymphomas and adult-onset Still's disease should be considered in the differential diagnosis of a patient admitted with FUO.

Accuracy of consultations performed by infectious diseases trainees and factors associated with adherence to them.

OBJECTIVES: Infectious diseases (ID) trainees should be familiar with duties relevant to consultation practice. In this study we aimed to analyze the ID trainee night/weekend shift consultation process in terms of consultant characteristics, types of recommendations, and compliance with recommendations. METHODS: All consultations performed by ID trainees on the night shift and at the weekends between 10 June and 10 August 2004 were recorded prospectively on standardized forms. Infectious diseases specialists assessed the appropriateness of recommendations the day after each consultation. Recommendations were considered complied with if they were carried out within 72 hours of the consultation. RESULTS: Of 440 consultations, 163 were for a clinically diagnosed infection (without specific antibiotic request) and 79 were for treatment continuation. Overall, 152 consultations were for requesting specific antibiotic(s), and 327 antibiotics were recommended or approved in 270 consultations. Eight of these recommendations were inappropriate. Overall compliance to ID recommendations was 75.3% (418/555). In univariate analysis, the compliance rate to non-treatment recommendations (microbiologic cultures, radiology, biochemistry, etc.) was found to be lower than the rate of compliance to antibiotic recommendations (186/308 vs. 232/247, p<0.05). In addition, compliance to recommendations made by the first-year trainees was lower than to the recommendations made by the other trainees. In logistic regression analysis only recommendations including antibiotic treatment was associated with higher compliance (p=0.0001, odds ratio=10.2, 95% CI=5.7-18.3). CONCLUSIONS: ID trainees are capable of evaluating patients and recommending appropriate antibiotics. Methodologies to improve the compliance to non-treatment-based recommendations and optimizing antibiotic selection seem to be necessary.

[Evaluation of specialist training in basic sciences in two university medical schools: perspectives from both specialist residents and trainers]. / Ege ve dokuz eylul Universitesi tip fakültelerinde temel tip bilimlerinde uygulanan uzmanlik egitiminin egitici ve egitilen BAkis açisi ile degerlendirilmesi.

A questionnaire survey has been undertaken to evaluate the specialist training in basic sciences in view of both specialist residents (SpRs) and trainers of two university medical schools in Izmir, Turkey. Seventy four SpRs (39 from Dokuz Eylül and 35 from Ege Universities) and 15 basic science units (8 from Dokuz Eyül and 7 from Ege Universities) were joined in this survey. The response rate was 73% for SpRs and 86.7% for basic science units. Technical equipments, the number of trainers, education programmes and training equipments of basic science units have been found adequate both by SpRs and trainers. However, professional education has been found incapable. In basic science units, it was seen that the SpRs are permanently assessed and attended the investigation activities during educational process. The trainers expressed that the SpRs have got training knowledge, skills and attitute sufficiently, but SpRs answered that they have got them in moderate means. In conclusion, although the training programmes of SpRs in both of the university hospitals have been found competent, SpRs indicated that there is a need for development of trainers quality, assessing methods and rotational education programmes in basic science.

[Specialist training in basic sciences in university hospitals: specialist resident perspective]. / Universite hastanelerinde temel bilimler alaninda uzmanlik egitimi: tipta uzmanlik ögrencisi bakis açisi ile.

In this study, a questionnaire survey including 56 questions and 154 variables has been undertaken for 74 specialist residents (SpRs) (39 from Dokuz Eylül and 35 from Ege Universities) who have been training in the two university hospitals of Izmir, for the detection of the structure of the actual training programmes, trainer profiles and technical institute equipments in the departments of Basic Sciences, Medical Pathology and Pharmacology. By using this survey, SpRs' demographic informations, training programmes, theoretical and skill activites, educational atmospheres, the trainers' profiles, assessments, audits and professionel developments have been questionned. The rate of response was 71%, and educational programmes, training and technical equipments, efficacy and number of the trainers were found satisfactory in each one of the universities. It has been detected that, the SpRs were permanently assessed and they were able to get training knowledges, skills and attitutes and attend investigation activities during their educational process. This survey study indicated that the training programmes, institute equipments and trainer profiles of the universities were competent for the SpRs'.