Bezbedna primena biljnih lekova u trudnoći i tokom perioda dojenja

Pregnancy is very specific period in which special warnings in drug use, including herbal drugs are recommended. This is related on period of lactation, too, since all drugs distributed and excreted into human milk potentially producing effects on nursing babies. There are no limits for use during pregnancy and lactation only for few herbal drugs. Some herbal drugs are contraindicated for use in these conditions due to their known adverse effects on fetus and newborns. However, for most herbal drugs there are no data, or they are very scarce, on the use during pregnancy and lactation. According to general recommendations in these cases, such herbal drugs should only be used after consulting a physician or under his supervision. However, for safety reasons, their use should be avoided every time if it is possible, especially in the first trimester when a fetus is the most vulnerable. Some herbal drugs can be used for therapy of pregnancy-related conditions (e.g. ginger for nausea and vomiting, and Lini semen, Plantaginis ovatae semen/testa and Psyilii semen for constipation). The use of herbal drugs for stimulation of lactation is traditional, and for none of them a clinical confirmation on efficacy and safety exist.Trudnoća je veoma specifičan period u kome treba biti posebno oprezan pri primeni lekova, uključujući i biljne. Ovo se odnosi i na period dojenja, budući da se svi lekovi, u većem ili manjem stepenu, raspodeljuju i izlučuju mlekom s mogućim ispoljavanjem dejstava na odojče. Za manji broj biljnih lekova ne postoji ograničenje za primenu u ovim stanjima, neki su kontraindikovani zbog poznatih neželjenih efekata na plod i odojče, dok za najveći broj biljnih lekova podaci o primeni u trudnoći i tokom perioda dojenja ne postoje ili su nepotpuni. U skladu sa opštom medicinskom praksom, oni se ne smeju koristiti bez savetovanja i nadzora lekara. Međutim, iz bezbednosnih razloga, najbolje je izbegavati ih tokom trudnoće i dojenja, kada god je to moguće, naročito u prvom trimestru kada je fetus najosetljiviji. Izvesne biljne droge mogu da se koriste za terapiju propratnih tegoba u trudnoći (npr. rizom đumbira, Zingiberis rhizoma kod mučnine i povraćanja, seme lana, Lini semen, seme i semenjača ispagule, Plantaginis ovatae semen/testa i seme indijske bokvice, Psyllii semen kod opstipacije). Primena biljnih droga za stimulaciju laktacije isključivo je tradicionalna, tj. ni za jednu ne postoji klinička potvrda efikasnosti i bezbednosti ovakve primene

Influence of some Stachys taxa on carrageenan-induced paw edema in rats

This work investigates the anti- inflammatory activity of methanol extracts of four endemic Stachys ( Labiatae) taxa from the Balkans: S. beckeana Dorfler & Hayek, S. anisochila Vis. et Pancic, S. plumosa Griseb., and S. alpina L. subsp. dinarica Murb. As a model of acute inflammation, carrageenan- induced paw edema in rats was used. Extracts, applied at doses of 50, 100, and 200 mg/ kg p. o., exhibited dose- dependent activity. S. beckeana and S. anisochila extracts were the most active ones ( ED50 154.52 and 162.24 mg/ kg, respectively), with the activity comparable with indomethacin at doses of 2 and 4 mg/ kg. S. plumosa extract has shown less- pronounced anti- inflammatory effect ( ED50 220.81 mg= kg). Extract of S. alpina subsp. dinarica had the lowest efficiency, attenuating inflammation less than 50%

Značaj racionalne primene lekova u veterinarskoj medicini za bezbednost hrane

Rational use of drugs in veterinary medicine has manifold significance. By using each drug, only when it is really necessary (indicated), in right dose and route of administration, the potential damage of their use is reduced, efficiency increased, and the risk of microorganisms resistance development (in case of antimicrobials) significantly decreased. All of this becomes more important when these drugs are used in food producing animals. Simultaneously with the intensifying of cattle breeding and exceptional increase of animal productivity, the number of used drugs is unavoidably increased. There are almost no animals today in intensive as well as in extensive production/rearing system, which haven't received at least one drug during their life. In poultry, cattle and pig production, which are main sectors for production of food stuffs of animal origin, the use of drugs has increased and reached the limits which are considered alarming for health of people. On the first place are antibiotics, or antimicrobial drugs, which are used very often in therapy or prevention of bacteria diseases, and also, very often, as growth stimulator. In addition to antibiotics, many other drugs are used, with proven numerous harmful effects, even with carcinogenic and teratogenic features, whose residues in food intended for human consumption can very seriously endanger the health of people, as potential consumers of this kind of food. Therefore, the control of use of antimicrobial, and other drugs in livestock production is exceptionally significant.Racionalna primena lekova u veterinarskoj medicini ima višestruk značaj. Korišćenjem lekova samo kada su stvarno neophodni (indikovani), u pravoj dozi i na pravi način, smanjuje se potencijalna šteta od njihovog korišćenja, a ujedno se povećava delotvornost, i smanjuje rizik od nastanka rezistentnosti mikroorganizama (odnosi se na antimikrobne lekove). Sve navedeno postaje još važnije kada se veterinarski lekovi koriste u lečenju farmskih životinja, odnosno životinja čiji se proizvodi koriste za ishranu ljudi. Istovremeno sa intenziviranjem stočarske proizvodnje i povećanjem produktivnosti životinja, povećava se i broj lekova koji se koriste. Danas ne postoji skoro nijedna životinja, u intenzivnom, kao i ekstenzivnom uzgoju, koja nije primila barem jedan lek tokom svog života. U živinarstvu, govedarstvu i svinjarstvu, kao glavnim sektorima gde se proizvode prehrambeni proizvodi životinjskog porekla, upotreba lekova je dostigla granice koje se mogu smatrati alarmantnim za zdravlje ljudi. Na prvom mestu su antibiotici, ili antimikrobni lekovi, koji se veoma često koriste u terapiji ili prevenciji bakterijskih bolesti, a ne tako retko i kao promotori rasta. Osim antibiotika, koriste se i mnogi drugi lekovi, koji imaju dokazano štetno dejstvo, pa čak i kancerogene ili teratogene osobine/svojstva. Njihove rezidue u proizvodima životinjskog porekla koji se koriste u ljudskoj ishrani, mogu veoma ozbiljno da ugroze zdravlje ljudi, koji su potencijalni konzumenti ove vrste hrane. Zbog toga je kontrola primene antimikrobnih lekova, kao i ostalih lekova u stočarstvu, od izuzetne važnosti

In vitro ispitivanje adsorpcije vitamina B1, B2 i B6 na zeolit

Background/Aim. Zeolites are the hydratised alumosilicates of alcali and earthalcali cations, which have a long three-dimensional crystal structure. Preparations on the basis of zeolites are used for adsorption of organic and nonorganic toxic substances and they, also, find more and more use in veterinary and human medicine and pharmacy. The aim of this study was to evaluate the possibilities of zeolite to adsorb vitamins B1, B2 and B6 in acid and neutral solutions, as well as the characteristics of the process (saturability, reversibility and competitivness). Methods. The specific and sensitive HPLC method with fluorescent detector was used for determination of vitamins B1, B2 and B6. Analyte separation and detection were carried out by applying the reverse-phase method on column C18. An in vitro experiment was done by testing the influence of pH value (2 and 7), concentration of vitamin solution (1, 2 and 5 mg/L), the lenght of contact with zeolite (10-180 min) and cation competitiveness on the exchange capacity, which is achieved by media and zeolite contact, as well as a possible vitamins desorption through changing pH value of the solution at 37°C. Jon competitiveness was examined by adding commercial feed mixture (grower) with a defined content of the examined vitamines in zeolite solutions the pH = 2 and pH = 7. Results. Vitamins B1, B2 and B6 were stable in both pH=2 and pH = 7 solutions at 37°C, in the defined time intervals. In acid solution concentrations of vitamins significantly declined in the first 10 min, with no significant decline in further 30 min for all the three concentrations testch. In neutral solution, after the addition of 1% zeolite, decrease in vitamins concentrations was slightly lower than in acid solution, but also significant in the first 10 min of the contact with zeolite. It was found that zeolite, which adsorbed vitamins in acid solution, transferred in the neutral one released a significant quantity of adsorbed vitamins after 30 min of extraction on 37°C. Vitamins B1, B2 and B6 from a commercial feed mixture in pH = 2 solution, at 37°C, were significantly adsorbed on zeolite after 30 min of the contact (21.87%, 20.15% and 4.53%, respectively), while in neutral solution there was no statistically significant adsorption. Conclusion. Zeolite significantly adsorbs vitamins B1, B2 and B6 in acid and neutral solutions at 37°C, already in the first 10 min of the contact. Adsorption was irreversible, but partly reversible after changing pH from acid to neutral. This is a significant ions competition for adsorption on zeolite in neutral solution, so no statistically significant vitamins B1, B2 and B6 adsorption occurs, while in acid solution competition is less, thus zeolite significanthy adsorbs these vitamins, although in less degree than in conditions with no concurrent ions.Uvod/Cilj. Zeoliti su hidratisani alumosilikati alkalnih i zemnoalkalnih katjona koji imaju dugu trodimenzionalnu kristalnu strukturu. Preparati na bazi zeolita koriste se za adsorpciju toksičnih materija organskog i neorganskog porekla i nalaze sve širu primenu u veterinarskoj i humanoj medicini i farmaciji. Cilj ovog rada bio je ispitivanje sposobnosti zeolita da adsorbuje vitamine B1, B2 i B6 u kiselom i neutralnom rastvoru, kao i karakteristike tog procesa (saturabilnost, reverzibilnost i konkurentnost). Metode. Za određivanje vitamina B1, B2 i B6 korišćena je HPLC metoda, uz primenu fluorescentnog detektora. Separacija analita izvedena je primenom reverznofazne metode na koloni C18. U in vitro uslovima vršeno je ispitivanje uticaja pH (2 i 7), koncentracije rastvora vitamina (1, 2 i 5 mg/L), dužine kontakta sa zeolitom (0-180 min) i konkurentnosti katjona na kapacitet izmene koji se postiže u kontaktu medijuma i zeolita, kao i moguća desorpcija vitamina promenom pH vrednosti rastvora pri temperaturi od 37 °C. Uticaj konkurentnosti jona na stepen adsorpcije vitamina B1, B2 i B6 na zeolit ispitivana je dodavanjem standardne hrane za tov pilića sa definisanim sadržajem ispitivanih vitamina u rastvor zeolita pH = 2 i pH = 7. Rezultati. Vitamini B1, B2 i B6 bili su stabilni u rastvoru pH = 2 i 7 na 37°C, u vremenskom intervalu praćenja do 180 min. U kiselom rastvoru vitamina, dodatkom 1% zeolita, koncentracija vitamina značajno je opadala prvih 10 min, a nakon 30 minuta neznatno za sve tri posmatrane koncentracije. U neutralnom rastvoru, dodatkom 1% zeolita, sniženje koncentracije vitamina bilo je nešto manje nego u kiselom rastvoru, ali, takođe, značajno prvih 10 min. Ustanovljeno je da zeolit koji je adsorbovao vitamine u kiselom rastvoru prenet u neutralan rastvor, nakon 30 min ekstrakcije na 37°C, otpušta značajnu količinu adsorbovanih vitamina. Vitamini B1, B2 i B6 iz hrane u rastvoru pH = 2 na 37°C, posle 30 minuta kontakta, značajno su adsorbovali na zeolit (21,87%, 20,15% i 4,53%, redom), dok je u neutralnom rastvoru izostala njihova statistički značajna adsorpcija. Zaključak. Postoji značajna adsorpcija vitamina B1, B2 i B6 na zeolit u kiselom i neutralnom rastvoru na 37°C već posle 10 min kontakta. Adsorpcija je ireverzibilna u pojedinačnim rastvorima, a reverzibilna nakon promene pH rastvora iz kiselog u neutralan. U neutralnom rastvoru postoji značajna konkurentnost jona za adsorpciju vitamina B1, B2 i B6 na zeolit, pa ne dolazi do njihove statistički značajne adsorpcije, za raliku od kiselog rastvora u kome je konkurentnost manja i zeolit značajno adsorbuje ove vitamine, premda u znatno manjem stepenu od onog, u uslovima odsustva konkurentnih jona

Neracionalna potrošnja lekova u veterinarskoj medicini - opasnost po zdravlje životinja i ljudi

The pharmaceutical industry, which allowed the achievements of contemporary medicine, has been extremely developed during the last five decades. At the same time, nonrational use of drugs also increased. Thus usage of many medicines confirmed their effectiveness, but at the same time the reports about unwanted and harmful effects became frequent. Uncontrolled use of antimicrobial drugs in production animals, does not only compromise their health, but also through the food the human health.Tokom poslednjih pet decenija farmaceutska industrija je izrasla u jednu od najmoćnijih industrijskih grana, bez koje se savremena medicina ne može ni zamisliti. Međutim, uporedo sa razvojem farmaceutske industrije sve više je rasla i neracionalna potrošnja lekova, a time i češća pojava neželjenih efekata. Poseban značaj ima neracionalna primena antimikrobnih lekova kod životinja namenjenih za ishranu ljudi, jer može da ugrozi ne samo zdravlje tretiranih životinja, već i ljudi

Analiza kliničkih ispitivanja za procenu efikasnosti i bezbednosti kvetiapina u terapiji velike depresije

In this review is shown the analysis of clinical studies of the efficacy and safety of atypical antipsychotic extended release quetiapine, in the treatment of adult patients with major depressive disorder (MDD), as short-term monotherapy, short-term adjunctive treatment to on-going antidepressant and maintenance treatment or relapse prevention in major depressive episodes. Recommended dosing regimen was 50 to 300 mg daily. Six of seven studies were positive on the primary efficacy variable (MADRS, Montgomery Asberg Depression Rating Scale score) on at least one dose under investigation, whilst one study was not significant. None of the studies was positive on the secondary endpoint: improvement in the quality of life, by assessing the change in Q-LES-Q total score (Quality of Life Enjoyment and Satisfaction Questionnaire). Overall, the safety findings from the extended release quetiapine MDD clinical studies are consistent with known adverse event profile for quetiapine in other known indications: schizophrenia and bipolar disorder. However, during the short-term exposure in the extended release quetiapine MDD clinical studies, the long-term serious adverse events, in particular risk related to metabolic changes, and possibility of tardive dyskinesia and increased risk of sudden cardiac death, has not been adequately studied, therefore the risk benefit ratio, for now, can not be assessed as favorable, with high reliability. Despite that, the regulatory authorities in the U.S. (FDA - Food and Drug Administration) and EU (EMA - European Medicines Agency) have approved, however, reduced indication for extended release quetiapine in the treatment of major depressive disorder: add-on treatment of major depressive episodes in patients with MDD who had suboptimal response to antidepressant monotherapy, noting that, prior to initiating treatment, clinicians should consider the safety profile of extended release quetiapine.U radu je prikazana analiza kliničkih studija za procenu efikasnosti i bezbednosti atipičnog antipsihotika kvetiapina, u obliku tableta sa produženom brzinom oslobađanja kod odraslih pacijenata sa velikom depresijom, primenjenog kao: kratkotrajna monoterapija, kratkotrajna dodatna terapija na primenjivani antidepresiv i monoterapija održavanja u prevenciji relapsa epizode velike depresije. Preporučen opseg doza kvetiapina u ovim studijama bio je 50 do 300 mg/dan. Rezultati šest od sedam sprovedenih kliničkih studija pokazali su da je kvetiapin u obliku tableta sa produženom brzinom oslobađanja statistički značajno efikasniji u odnosu na placebo, s obzirom na primarni parametar efikasnosti, promenu ukupnog MADRS skora (Montgomery Asberg Depression Rating Scale Score) za bar jednu od doza koje su ispitivane u studijama, dok u jednoj od studija nije pokazana statistički značajna razlika između kvetiapina i placeba, u odnosu na ovaj parametar efikasnosti. Niti u jednoj od studija kvetiapin u obliku tableta sa produženim oslobađanjem nije bio statistički značajno efikasniji od placeba u odnosu na sekundarni parametar efikasnosti: poboljšanje kvaliteta života procenjeno na osnovu promene ukupnog skora Q-LES-Q upitnika (Quality of Life Enjoyment and Satisfaction Questionnaire total score). Profil neželjenih efekata kvetiapina u obliku tableta sa produženim oslobađanjem u sprovedenim kliničkim studijama na pacijentima sa velikom depresijom nije se razlikovao od poznatog bezbednosnog profila kvetiapina ustanovljenog u ranije odobrenim indikacijama za ovaj lek (shizofrenija i bipolarni poremećaj). Međutim, kratkotrajna izloženost pacijenata sa velikom depresijom kvetiapinu u sprovedenim kliničkim studijama, nije dovoljna za procenu rizika od njegovih dugoročnih ozbiljnih neželjenih efekata kao što su: metabolički poremećaji, potencijalni rizik za razvoj tardivne diskinezije i mogućnost povećanja rizika od iznenadne srčane smrti, tako da se odnos korist/rizik primene ovog leka kod pacijenata sa velikom depresijom, još uvek ne može, sa velikom pouzdanošću, proceniti kao povoljan. Uprkos tome, regulatorna tela u SAD (FDA - Food and Drug Administration) i EU (EMA - European Medicines Agency) odobrila su, doduše, suženu indikaciju za kvetiapin u obliku tableta sa produženim oslobađanjem u terapiji velike depresije: dodatna terapija (add-on) kod pacijenata sa velikom depresijom, koji su imali suboptimalan odgovor na monoterapiju antidepresivom, uz napomenu da, pre započinjanja terapije, lekari treba da razmotre profil bezbednosti ovog leka

Farmakološka karakterizacija dekokta herbe Cirsium ligulare Boiss. (Asteraceae)

Background/Aim. Data on phytochemical and pharmacological investigations of genus Cirsium Mill. (Asteraceae) are scarce. Some data suggest that decoctions or infusions prepared from these plants are used in folk medicine as tonics, particularly in inflammatory, liver and stomach diseases. So far there have been no pharmacological investigations related to Cirsium ligulare (C. ligulare) Boiss. Accordingly, the aim of this study was to estimate antioxidative, anti-inflammatory and gastroprotective activities of aqueous extracts of C. ligulare herb prepared as 5% and 10% decoctions. Methods. Antioxidative activity was determined using the method of 2,2-diphenyl-1- picrylhydrazyl (DPPH) radical scavenging. Investigations of anti-inflammatory (a model of systemic inflammatory response induced by endotoxin of Escherichia coli and carrageenaninduced rat paw oedema model for local inflammatory response), as well as gastroprotective effects (a model of stress-ulcer induced by absolute ethanol), were conducted in adult female Wistar rats that were given the aqueous extracts of C. ligulare herb per os. Indomethacin and ranitidine were used as reference drugs for evaluation of local anti-inflammatory and gastroprotective effects, respectively. Results. The results demonstrated that aqueous extracts of C. ligulare herb produced strong antioxidative activity, diminished body weight loss induced by endotoxin, significantly reduced carrageenan-induced paw oedema, and prevented the ulcerogenic action of absolute ethanol. Both anti-inflammatory and gastroprotective activities of the extract tested were comparable to those of the reference drugs. Conclusion. Presented results justify the traditional use of C. ligulare herb decoctions and further phytochemical and pharmacological investigations are warranted.Uvod/Cilj. Biljke roda Cirsium su hemijski i farmakološki nedovoljno ispitane. Tradicionalno se dekokti ili infuzi ovih biljaka koriste kao tonici, naročito kod zapaljenjskih procesa, kao i kod bolesti jetre i želuca. Vrsta Cirsium ligulare (C. ligulare) Boiss. do sada nije farmakološki ispitivana. Stoga je cilj ovog istraživanja bio da se proceni antioksidantna, antiinflamatorna i gastroprotektivna aktivnost vodenog ekstrakta herbe C. ligulare izrađenog kao 5% i 10% dekokt. Metode. Ispitivanje antioksidantne aktivnosti vršeno je testom neutralizacije 2,2-diphenyl-1-picrylhydrazyl (DPPH) radikala. Ispitivanje antiinflamatornog (model sistemskog inflamatornog odgovora indukovan endotoksinom bakterije Escherichia coli i karageninom-indukovani edem šape pacova kao model lokalne inflamcije), kao i gastroprotektivnog efekta (model ulkusa indukovanog apsolutim etanolom), sprovedeno je na odraslim ženkama pacova Wistar soja, kojima su per os dati vodeni ekstrakti herbe C. ligulare. Kao referentni lekovi prilikom ispitivanja lokalnog antiinflamatornog i gastroprotektivnog delovanja, primenjeni su indometacin i ranitidin, redom. Rezultati. Rezultati pokazuju da su ispitivani vodeni ekstrakti herbe C. ligulare ispoljili jaku antioksidantnu aktivnost, smanjili gubitak telesne mase indukovan endotoksinom, značajno redukovali karageninom indukovani edem šape pacova i spečili ulcerogeni efekat apsolutnog etanola. Antiinflamatorna i gastroprotektivna aktivnost ispitivanih ekstrakata bila je uporediva sa aktivnošću referentnih lekova. Zaključak. Dobijeni rezultati u značajnoj meri opravdavaju tradicionalnu primenu dekokta herbe C. ligulare, a planiraju se i dodatna hemijska i farmakološka ispitivanja ove droge

Bezbednost primene antimikrobnih lekova

The discovery and introduction of antimicrobial drugs in clinical practice has been recorded as one of the greatest achievements in the history of medicine. The application of these drugs, made a big, almost revolutionary upheaval in treatment of many infectious diseases. Its significance for the humanity lies in the fact that hundreds of thousands of people, until then condemned to a certain death, has been saved now. However, it was shown that antimicrobial therapy carries some risk of possible occurrence of undesirable and toxic effects, such as direct toxic effects, development of resistance, the impact on the normal microflora or disorder of micropopulation metabolic functions in digestive tract of ruminants, unwanted interactions with other drugs, damage or necrosis of the tissue at the injection site, residues in foodstuff intended for human consumption, suppression of immune system or defense mechanisms of the body, and damage of fetal or neonatal tissue. All mentioned, directly or indirectly, to a greater or lesser degree can reduce the safety of these drugs.Otkriće i uvođenje antimikrobnih lekova u kliničku praksu zabeleženo je kao jedno od najvećih dostignuća u istoriji razvoja medicine. Primenom ovih lekova, napravljen je veliki, gotovo revolucionarni preokret u lečenju brojnih infektivnih bolesti. Kolikije to značaj za čovečanstvo, najbolje govori podatak da je na stotine hiljada ljudi, do tada osuđeno na sigurnu smrt, sada bilo spašeno. Međutim, s vremenom se pokazalo da antimikrobna terapija nosi sa sobom i određeni rizik od moguće pojave neželjenih i toksičnih efekata, kao što su: direktno toksično delovanje, razvoj rezistencije, uticaj na normalnu mikrofloru ili poremećaj metaboličke funkcije mikropopulacije u digestivnom traktu preživara, neželjene interakcije sa drugim lekovima, oštećenje ili nekroza tkiva na injekcionom mestu, rezidue u namirnicama namenjenim za ishranu ljudi, supresija imunog sistema, odnosno odbrambenih mehanizama organizma, te oštećenje fetalnih ili neonatalnih tkiva. Svi oni na direktan ili indirektan način, u manjem ili većem stepenu mogu da umanje bezbednost primene ovih lekova

Faktori koji utiču na cenu antibiotske terapije i ishod kod kritično obolelih pacijenata - 'real-life' studija

Background/Aim. Critically ill patients are at very high risk of developing severe infections in intensive care units (ICUs). Procalcitonin (PCT) levels are eleveted in the circulation in patients with bacterial sepsis and PCT might be useful in guiding antibiotic treatment. The aim of this study was to estimate factors influencing patients survival and treatment cost in ICU with special emphasis on the impact of PCT serum levels use in guiding antimicrobial therapy. Methods. The study was conducted from August 2010 to May 2012 in the Intensive Therapy Unit, Clinic of Anesthesiology and Intensive Therapy, Military Medical Academy (MMA), Belgrade, Serbia. All adult critically ill patients with sepsis and/or trauma admitted in the ICU were included in the study. This study included only the cost of antimicrobial therapy in the ICU and the cost for PCT analysis. We used prices valid in the MMA for the year 2012. PCT in serum was measured by homogeneous immunoassay on a Brahms Kryptor analyzer. Results. A total of 102 patients were enrolled. The mean patients age was 55 ± 19 years and 61.8% of patients were male. The mean length of stay (LOS) in the ICU was 12 ± 21 days. There was a statistically significant difference (p lt 0.001) between the sepsis and trauma group regarding outcome (higher mortality rate was in the sepsis group, particularly in the patients with peritonitis who were mostly women). The patients younger than 70 years had better chance of survival. LOS, the use of carbapenems and PCT-measurement influenced the cost of therapy in the ICU. Conclusions. The obtained results show that age, the diagnosis and gender were the main predictors of survival of critically ill patients in the ICU. The cost of ICU stay was dependent on LOS, use of carbapenems and PCT measurement although the influence of these three factors on the outcome in the patients did not reach a statistical significance.Uvod/Cilj. Kritično oboleli pacijenti imaju veliki rizik od razvoja teških infekcija u jedinicama intenzivne terapije (JIT). Nivo prokalcitonina (PCT) u cirkulaciji je povišen kod bolesnika sa bakterijskom sepsom, tako da PCT može biti koristan u praćenju antibiotske terapije. Cilj ove studije bio je da se ustanove faktori koji utiču na ishod i troškove lečenja u JIT u našoj ustanovi sa posebnim naglaskom na uticaj korišćenja serumskog nivoa PCT u vođenju antimikrobne terapije. Metode. Studija je sprovedena od avgusta 2010. godine do maja 2012. godine u Jedinici intenzivne terapije Klinike za anesteziologiju i intenzivnu terapiju Vojnomedicinske akademije (VMA) u Beogradu, Srbija. Svi kritično oboleli sa sepsom i/ili traumom koji su primljeni u JIT bili su uključeni u studiju. Studijom su obuhvaćeni samo troškovi antimikrobne terapije u JIT i troškovi PCT analize. Koristili smo cenovnik VMA za 2012. godinu. PCT u serumu je meren tehnikom homogenog imunoeseja na Brams Kriptor analizatoru. Rezultati. Studijom su bila obuhvaćena 102 bolesnika. Prosečna starost bolesnika iznosila je 55 ± 19 godina, a 61,8% bolesnika bili su muškarci. Prosečna dužina boravka u JIT (lenght of stay LOS) iznosila je 12 ± 21 dana. Postojala je statistički značajna razlika (p lt 0.001) između ishoda lečenja u grupi sa sepsom u odnosu na grupu sa traumom. Bolesnici mlađi od 70 godina imali su bolju šansu da prežive. Dužina boravka, upotreba karbapenema i merenje PCT uticali su na cenu terapije u JIT. Zaključak. Dobijeni rezultati pokazuju da su godine života, dijagnoza i pol bili glavni prediktori preživljavanja kritično obolelih u JIT. Cena terapije zavisila je od dužine boravka u JIT, upotrebe karbapenema i merenja PCT, ali uticaj ovih faktora na ishod lečenja nije dostigao statističku značajnost