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001-es BibID:	BIBFORM135896
Első szerző:	Fésüs Adina (gyógyszerész)
Cím:	Evaluation of Antibiotic Use in Patients Admitted to a Hungarian Intensive Care Unit with Pneumonia and Sepsis : retrospective Observational Before-After Study / Adina Fésüs, Zsanett Szilágyi, Zsuzsa Beniczky, Eszter Varga, Mária Matuz, Krisztina Gaál, Sándor Somodi, Ildikó Bácskay, István Lekli, Attila Vaskó
Dátum:	2026
Megjegyzések:	Background: Early and adequate empiric antibiotic therapy is essential in the treatment of pneumonia and sepsis and may influence the clinical outcome. Aims and Objectives: This retrospective before?after study aimed to appraise the impact of a local Antibiotic Stewardship Program (ASP?written guidelines and antibiotic restriction) on antibiotic (AB) use and clinical outcomes in patients requiring intensive care due to pneumonia and sepsis. Methods: This study was conducted as a single-center, retrospective observational study in the intensive care unit (ICU) of a pulmonology department of a tertiary care center. Data were collected for the pre-intervention period between January 2018 and May 2022 and for the ASP period between June 2022 and March 2024. In addition to descriptive statistics and univariable methods, interrupted time series (ITS) analysis was used to assess AB use and length of stay in the ICU before and after ASP implementation, using a segmented linear regression with a fixed breakpoint and continuous (hinge) specification. Results: The patients admitted to the ICU with pneumonia and sepsis were mainly men (58/101, 57.4% and 84/128, 65.6%), the need for intensive care increased with age, and most of the patients belonged to 65+ age group in both study phases (69/101, 68.3% and 75/128, 58.6%). The majority of the patients had four or more comorbidities (58/101, 57.4% and 52/128, 40.6%). In-hospital mortality was relatively high (42.6% and 41.4%), with most of the patients losing their lives in the ICU (33/43, 76.7% and 37/53, 69.8%). Significant increase in guideline-adherent agent selection (34.5%) and use of combination therapy (35.0%) was observed, while the use of fluoroquinolones decreased significantly (?31.1%). In the after period, a significant decrease in the number of patients using restricted ABs (?53.3%) was observed. In one-third of these cases (10/34, 29.4% and 16/40, 40%), two to four multidrug-resistant pathogens (MDRs) were detected simultaneously, resulting in a significant increase in direct costs (10.5%) in the ICU. The inappropriate use of AB therapy was relatively low in the presence of MDRs in both phases (2/34, 5.9% and 6/40, 15%). In the ASP period, guideline adherence was associated with slightly better clinical outcomes (30-day mortality: ?0.8%; length of stay: ?22.6%) in pneumonia and sepsis. The ITS analyses after the ASP implementation showed a weak downward trend and before it a slight increasing trend. Conclusions: ASP implementation in the ICU resulted in a significant improvement in the appropriate use of ABs, and guideline adherence led to slightly better clinical outcomes. Our results suggest that ASP may offer improved antimicrobial resistance with a sustained long-term effect.
Tárgyszavak:	Orvostudományok Gyógyszerészeti tudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk antibiotic guideline-adherent length of stay MDR pathogen pneumonia sepsis 30-day mortality
Megjelenés:	Antibiotics. - 15 : 3 (2026), p. 1-21. -
További szerzők:	Szilágyi Zsanett (2001-) (gyógyszerész) Beniczky Zsuzsa Varga Eszter (1992-) (gyógyszerész) Matuz Mária Gaál Krisztina (1976-) (belgyógyász szakorvos) Somodi Sándor (1977-) (belgyógyász) Bácskay Ildikó (1969-) (gyógyszerész, gyógyszertechnológus) Lekli István (1981-) (gyógyszerész) Vaskó Attila (1976-) (tüdőgyógyász)
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001-es BibID:	BIBFORM117047
035-os BibID:	(WoS)001131414900001 (Scopus)85180471743
Első szerző:	Fésüs Adina (gyógyszerész)
Cím:	Evaluation of the Diagnosis and Antibiotic Prescription Pattern in Patients Hospitalized with Urinary Tract Infections : single-Center Study from a University-Affiliated Hospital / Adina Fésüs, Mária Matuz, Erika Papfalvi, Helga Hambalek, Roxána Ruzsa, Bence Tánczos, Ildikó Bácskay, István Lekli, Árpád Illés, Ria Benkő
Dátum:	2023
ISSN:	2079-6382
Megjegyzések:	UTIs (urinary tract infections) are common bacterial infections with a non-negligible hospitalization rate. The diagnosis of UTIs remains a challenge for prescribers and a common source of misdiagnosis. This retrospective observational study aimed to evaluate whether recorded diagnosis by clinicians and empirical antibiotic therapy met the EAU (European Association of Urology) guideline in patients hospitalized with UTI. The study was conducted at an internal medicine unit of a tertiary care medical center in Hungary. The diagnosis was assessed based on clinical presentation, physical examination, and laboratory (including microbiological) results, considering all the potential risk factors. Diagnosis was considered misdiagnosis when not confirmed by clinical presentation or clinical signs and symptoms. Evaluation of empirical antibiotic therapy was performed only for confirmed UTIs. Empirical treatment was considered guideline-adherent when complying with the relevant recommendations. Out of 185 patients, 41.6% failed to meet EAUbased UTI diagnosis criteria, of which 27.6% were misdiagnosed and 14.1% were ABU (asymptomatic bacteriuria). The diagnosis of urosepsis recorded at admission (9.7%, 18/185) was not confirmed either by clinical or microbiological tests in five (5/18) cases. The initial empirical therapies for UTI showed a relatively low rate (45.4%) of guideline adherence regarding agent selection. The most common guideline-non-adherent therapies were combinations with metronidazole (16.7%). Dosage appropriateness assessments showed a guideline adherence rate of 36.1%, and underdosing due to high body weight was common (9.3%). Overall (agent, route of administration, dose, duration) guideline adherence was found to be substantially low (10.2%). We found a relatively high rate of misdiagnosed UTIs. Written protocols on the ward may be crucial in reducing misdiagnosis and in optimizing antibiotic use.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk urinary tract infection missdiagnosis empirical therapy
Megjelenés:	Antibiotics-Basel. - 12 : 12 (2023), p. 1-19. -
További szerzők:	Matuz Mária Papfalvi Erika Hambalek Helga Ruzsa Roxána Tánczos Bence (1987-) (biológus) Bácskay Ildikó (1969-) (gyógyszerész, gyógyszertechnológus) Lekli István (1981-) (gyógyszerész) Illés Árpád (1959-) (belgyógyász, haematológus, onkológus) Benkő Ria
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001-es BibID:	BIBFORM110546
Első szerző:	Fésüs Adina (gyógyszerész)
Cím:	Felnőttkori közösségben szerzett pneumonia (CAP) empirikus antibiotikum-terápiája - Nemzetközi és hazai irányelvek = Empirical antibiotic therapy in community-acquired pneumonia (CAP) / Fésüs Adina, Bácskay Ildikó, Matuz Mária, Benkő Ria
Dátum:	2023
Tárgyszavak:	Orvostudományok Gyógyszerészeti tudományok magyar nyelvű folyóiratközlemény hazai lapban folyóiratcikk
Megjelenés:	Gyógyszerészet. - 67 : 3 (2023), p. 115-125. -
További szerzők:	Bácskay Ildikó (1969-) (gyógyszerész, gyógyszertechnológus) Matuz Mária Benkő Ria
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001-es BibID:	BIBFORM110530
Első szerző:	Fésüs Adina (gyógyszerész)
Cím:	The pharmacist's role in optimising surgical antibacterial prophylaxis (SAP) / A. Fésüs, R. Benkő, M. Matuz, Z. Engi, R. Ruzsa, H. Hambalek, Á. M. Fésüs, T. Bazsó, Z. Csernátony, I. Bácskay, G. Kardos
Dátum:	2023
Megjegyzések:	Background and importance Perioperative antibiotic use is a common reason for antibiotic misuse. Evidence suggests that adherence to SAP guidelines may improve outcomes. Aim and objectives The purpose of this study was to analyse the impact of pharmacist-led antibiotic stewardship interventions on SAP guideline compliance. Materials and methods The study was conducted at an Orthopedic Department of a tertiary care medical center. SAP compliance and antibiotic exposure in the pre-intervention and intervention period was compared using chi-square, Fisher exact, and Mann-Whitney tests, as appropriate. Prophylactic antibiotic use in orthopedic joint arthroplasties (overall guideline adherence: agent, dose, frequency, duration), clinical outcomes (length of stay-LOS, number of surgical site infections-SSIs), antibiotic exposure and direct antibiotic costs were compared between pre-intervention and intervention periods. Results Significant improvement in mean SAP duration (by 42.9%, 4.1 ? 2.1 vs. 2.1 ? 1.9 days, p < 0.001), and overall guideline adherence regarding antibiotic use (by 56.2%, from 2% to 58.2%, p < 0.001) were observed. A significant decrease was observed in antibiotic exposure in SAP (by 41%, from 6.1 ? 0.05 to3.6 ? 4.3 DDD/patient, p < 0.001), average prophylactic antibiotic cost (by 54.8%, 9278.8 ? 6094.3 vs. 3598.2 ? 3354.6 HUF/patient), and mean LOS (by 37.2%, from 11.2 ? 7 to 7.62 ? 3 days, p < 0.001); and a slight decrease in the number of confirmed SSIs was found between the two periods (by 1.8%, from 3% to 1.2%, p = 0.21). Conclusion and relevance Continuous presence of the clinical pharmacist led to significant improvement in SAP guideline adherence, which was accompanied by decreased antibiotic exposure and cost.
Tárgyszavak:	Orvostudományok Gyógyszerészeti tudományok idézhető absztrakt folyóiratcikk
Megjelenés:	European Journal of Hospital Pharmacy. - 30 : Suppl1 (2023), p. A109-A110. -
További szerzők:	Benkő Ria Matuz Mária Engi Zsófia Ruzsa Roxána Hambalek Helga Fésüs Márton Á. Bazsó Tamás (1974-) (ortopéd sebész) Csernátony Zoltán (1959-2023) (ortopéd sebész, traumatológus) Bácskay Ildikó (1969-) (gyógyszerész, gyógyszertechnológus) Kardos Gábor (1974-) (absztraktok)
Pályázati támogatás:	TKP2021-EGA-18 Egyéb
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