Prospective analysis of infectious diseases consultations at Turkish University Hospital

Abstract

Background: Infectious diseases consultations are most important part of infectious diseases practice. The aim of this study was to analysis prospectively infectious disease consultations of our hospital that were officially requested during a period of 9 months.Materials and methods: In this study, 1315 written consultations that were requested from department of infectious disease and clinical microbiology between November 15, 2004 and August 15, 2005 were investigated prospectively. Results: Of the requested consultation cases, 59% (770) were male, 41% (545) were female (range: 15-92 years, mean: 53±18 years). Consultations were routine for 60% (792) and urgent for 40% (523).The departments most frequently requesting the consultation services were Medical Oncology (124, 9.4%), Intensive Care Unit (102, 7.8%), and General Surgery (83, 6.3%). The most frequent reasons of consultation request were fever (507, 38.6%), suspicion of infection (329, 25%), and positive microbiological culture (261, 19.8%). The most frequent purposes were diagnosis and treatment (791, 60.2%), treatment planning (227, 17.3%), and diagnosis (178, 13.5%). Recommendations were as follows: no antibiotic recommendation for 243 patients (18.5%), starting antibiotic therapy for 348 patients (%26.5), changing antibiotic therapy in 320 patients (24.3%), adding antibiotic to the current therapy in 87 patients (6.6%), stopping the current therapy in 107 patients (8.1%), increasing the dose in 9 patients (0.7%), and preoperative prophylaxis for 4 patients (0.3%). Conclusion: Infectious diseases consultations are very important for rational antibiotic treatment. Infectious diseases training programs should consist of not only communicable diseases, but also all system infections, antibiotic stewardship, infections in immunocompromised host, nosocomial infections, and differential diagnosis of non-infections causes which was seen frequently. Restericted antibiotic policy should be combined the education programme of antibiotic usage.