Title Upotreba antibiotika u liječenju bolesnika s upalnom bolesti crijeva
Title (english) Antibiotic treatment in inflammatory bowel disease patients
Author Helena Radiković
Mentor Silvija Čuković-Čavka (mentor)
Committee member Robert Likić (predsjednik povjerenstva)
Committee member Jasenka Markeljević (član povjerenstva)
Committee member Silvija Čuković-Čavka (član povjerenstva)
Granter University of Zagreb School of Medicine (Department of Internal Medicine) Zagreb
Defense date and country 2019-07-12, Croatia
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences Internal Medicine
Abstract Upalne bolesti crijeva su kroniĉne bolesti gastrointestinalnog sustava praćene brojnim komplikacijama i ekstraintestinalnim manifestacijama. Dvije najvažnije forme bolesti su Crohnova bolest i ulcerozni kolitis s brojnim fenotipovima. Prisutne su diljem svijeta s razlikama u epidemiologiji i izloženosti čimbenicima rizika. Incidencija upalnih bolesti crijeva u svijetu zadnjih desetljeća raste, te one postaju važan javnozdravstveni problem. Kako do danas nije nađen jedinstveni dijagnostički test za potvrdu ulceroznog kolitisa ili Crohnove bolesti, dijagnoza upalne bolesti crijeva rezultat je ukupne analize kliničke prezentacije i rezultata dijagnostičkih pretraga. Metode liječenja upalnih bolesti crijeva dramatino su napredovale u posljednjem desetljeću uvođenjem ciljane biološke terapije, optimizacijom postojećih oblika liječenja, te boljim razumijevanjem imunog sustava sluznice i genetike, uključenih u patogenezu upalne bolesti crijeva. Cilj terapije je postići i održati remisiju bolesti. Budući da se upalna bolest crijeva u većini slučajeva razvija u ranim godinama života, često je potrebno liječiti pacijente tijekom dugogodišnjeg razdoblja i prilagoditi terapiju u više navrata s obzirom na razvoj relapsa bolesti, komplikacije ili individualne potrebe pacijenata. Lijekovi koje primjenjujemo u ovih bolesnika su aminosalicilati, glukokortikoidi, imunomodulatori, antibiotici i u novije vrijeme biološki lijekovi. Glavne indikacije za upotrebu antibiotika u liječenju bolesnika s upalnom bolesti crijeva su septičke komplikacije bolesti, simptomi koji se mogu pripisati prekomjernom rastu bakterija ili perianalnoj bolesti, te refraktorni oblik bolesti koji ne odgovara na medikamentnu terapiju, a kirurški oblik liječenja je kontraindiciran. Uz medikamentnu terapiju, drugi oblik liječenja pacijenata s upalnim bolestima crijeva jest kirurški. Podaci koji se razmatraju u ovom diplomskom radu pregled su relevantnih znanstvenih publikacija, mišljenja stručnjaka i smjernica trenutne prakse.
Abstract (english) Inflammatory bowel diseases are chronic diseases of the gastrointestinal system followed by numerous complications and extraintestinal manifestations. The two most important types are Crohn's disease and ulcerative colitis with their numerous phenotypes. They present worldwide with differences in epidemiology and exposure to risk factors. The incidence of inflammatory bowel diseases has grown in the recent decades, and they have become an important public health problem. Since no single diagnostic test for confirming ulcerative colitis nor Crohn's disease has been found to date, the diagnosis of inflammatory bowel disease results from multiple diagnostic methods combined with the clinical presentation. Methods of inflammatory bowel disease treatment have dramatically advanced in the last decade due to better understanding of the immune system of mucous membranes and genetics involved in the inflammatory bowel disease pathogenesis by introducing targeted biological therapy and optimizing the existing forms of treatment. The goal of therapy is to achieve and maintain remission of the disease. Since inflammatory bowel disease in most cases develops early in life, it is often necessary to treat patients over a long period of time and adjust the therapy on several occasions with regard to the relapses of the disease, complications or individual patient needs. Drugs administered to these patients are aminosalicylates, glucocorticoids, immunomodulators, antibiotics and, more recently, biological drugs. The main indications for antibiotics in treatment of patients with inflammatory bowel disease are septic complications, symptoms that can be attributed to excessive bacterial growth or perianal disease, and refractory illnesses that do not respond to medication therapy, and if the surgical form of treatment is contraindicated. Beside with medication therapy, another form of treatment for patients with inflammatory bowel disease is surgery. The data considered in this paper are an overview of relevant scientific publications, expert opinions and current practice guidelines.
Keywords
upalna bolest crijeva
Crohnova bolest
ulcerozni kolitis
antibiotici
Keywords (english)
inflammatory bowel disease
Crohn’s disease
ulcerative colitis
antibiotics
Language croatian
URN:NBN urn:nbn:hr:105:426420
Study programme Title: Medicine Study programme type: university Study level: integrated undergraduate and graduate Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
Type of resource Text
File origin Born digital
Access conditions Open access
Terms of use
Created on 2020-02-17 16:21:47