Kafa Tabanı Osteomyeliti Olan Hastalarda Antimikrobiyal Tedaviyi Etkileyen Faktörler
Özet
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.