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    Comparison of piperacillin-tazobactam and vancomycin (TZP-VAN) with piperacillin-tazobactam and teicoplanin (TZP-TEI) for the risk of acute kidney injury (CONCOMITANT): A prospective observational, multinational, multi-centre cohort study
    (Elsevier, 2025) Aslan, Abdullah Tarik; Kara, Emre; Köksal, Gamze; Bilir, Yeliz; Saraçoğlu, Kemal Tolga; Eser, Fatma; Güner, Rahmet; Alkan, Sevil
    Objective: Both vancomycin (VAN) and teicoplanin (TEI) augment the risk of acute kidney injury (AKI) when combined with piperacillin-tazobactam (TZP). We aimed to compare the risk of AKI among patients receiving TZP-VAN vs. TZP-TEI. Methods: This was a prospective, multinational, multicentre cohort study conducted in 12 centres from Turkiye, Italy, and Spain between 1 June 2022, and 31 December 2023. The primary outcome was the occurrence of AKI between the first day of antibiotic treatment and the third day after completing therapy, according to the Kidney Disease Improving Global Outcomes criteria. Multivariable logistic regression and propensity-score match analyses were employed to adjust for confounding variables. Stratified Kaplan- Meier analysis was used to assess the time-to-AKI between the comparison groups. Results: Of 187 patients (TZP-TEI, n = 102; TZP-VAN, n = 85), the AKI occurred in 21 patients (24.7%) who received TZP-VAN and in 15 patients (14.7%) with TZP-TEI (unadjusted odds ratio [OR], 1.90; 95% CI: 0.91-3.97; P = 0.087). After adjusting for confounding variables with multivariable analysis, TZP-VAN was not associated with increased odds of AKI compared with TZP-TEI; with an adjusted OR of 2.24 (95% CI: 0.78-6.42; P = 0.133). In propensity-score matched analysis ( n = 49 pairs), the AKI risk was similar between the two groups (OR, 2.10; 95% CI: 0.67-6.50; P = 0.199). The stratified Kaplan-Meier analysis indicated no difference between the treatment groups in terms of time-to-AKI (log-rank test, P = 0.107). Conclusions: The risk of AKI in TZP-VAN was similar to that in TZP-TEI. These results should be confirmed in randomized controlled trials.
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    Switching to tenofovir alafenamide in hbv: nationwide real life data of efficacy and safety from Turkey
    (Wiley, 2021) Tabak, Fehmi; Yörük, Gülşen; Köksal, İftihar; Erdem, Hazal; Yıldız, Dilek; İnce, Nevin; Yamazhan, Tansu; Sume, Serkan; Batırel, Ayşe; Günal, Özgür; Yıldız, İlknur Esen; Sırmatel, Fatma; Koç, Meliha Merih; Çeken, Sabahat; Bozkurt, İlkay; Görenek, Levent; Şener, Alper; Köse, Şükran; Türker, Kamuran; İnan, Dilara; Karabay, Oğuz; Güner, Rahmet
    Tenofovir alafenamide (TAF) is a new prodrug of tenofovir used for the treatment of HIV-1 and HBV infections. It provides more efficient intracellular tenofovir concentrations at a relatively lower dose than provided by tenofovir disoproxil fumarate (TDF). TAF is expected to have efficacy similar to that of TDF with improved safety profile.
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    The Role of Pneumococcal Pneumonia among CommunityAcquired Pneumonia in Adult Turkish Population: TurkCAP Study
    (AVES, 2021) Şenol, Esin; Çilli, Aykut; Günen, Hakan; Şener, Alper; Dumlu, Rıdvan; Ödemiş, Ayşe; Topçu, Ayşe Füsun; Yıldız, Yeşim; Güner, Rahmet; Özhasenekler, Ayhan; Mutlu, Birsen; Köktürk, Nurdan; Sevimli, Nurgül; Baykam, Nurcan; Yapar, Derya; Ekin, Selami; Polatlı, Mehmet; Eren Gök, Şebnem; Kılınç, Oğuz; Sayıner, Abdullah; Karaşahin, Ömer; Çuhadaroğlu, Çağlar; Sesin Kocagöz, Ayşe; Togan, Turhan; Arpağ, Hüseyin; Katı, Hakan; Köksal, İftihar; Aksoy, Firdevs; Hasanoğlu, Canan
    OBJECTIVE: To evaluate the rate of pneumococcal pneumonia (PP) among patients with community-acquired pneumonia (CAP) in Turkey and to investigate and compare features of PP and non-PP CAP patients. MATERIAL AND METHODS: This multicenter, non-interventional, prospective, observational study included adult CAP patients (age = 18 years). Diagnosis of PP was based on the presence of at least 1 positive laboratory test result for Streptococcus pneumoniae (blood culture or sputum culture or urinary antigen test [UAT]) in patients with radiographic findings of pneumonia. RESULTS: Four hundred sixty-five patients were diagnosed with CAP, of whom 59 (12.7%) had PP. The most common comorbidity was chronic obstructive pulmonary disease (30.1%). The mean age, smoking history, presence of chronic neurological disease, and CURB-65 score were significantly higher in PP patients, when compared to non-PP patients. In PP patients, 84.8% were diagnosed based ony on the UAT. The overall rate of PP patients among CAP was calculated as 22.8% considering the UAT sensitivity ratio of 63% (95% confidence interval: 45-81). The rate of intensive care treatment was higher in PP patients (P =.007). While no PP patients were vaccinated for pneumococcus, 3.8% of the non-PP patients were vaccinated (P =.235). Antibiotic use in the preceding 48 hours was higher in the non-PP group than in the PP group (31.8% vs. 11.1%, P =.002). The CURB-65 score and the rate of patients requiring inpatient treatment according to this score were higher in the PP group. CONCLUSION: The facts that PP patients were older and required intensive care treatment more frequently as compared to non-PP patients underline the burden of PP.