التفاصيل البيبلوغرافية
| العنوان: |
Antimicrobial de-escalation in adult hematopoietic cell transplantation recipients with febrile neutropenia of unknown origin. |
| المؤلفون: |
Petteys, Megan M, Kachur, Ekaterina, Pillinger, Kelly E, He, Jiaxian, Copelan, Edward A, Shahid, Zainab |
| المصدر: |
Journal of Oncology Pharmacy Practice; Apr2020, Vol. 26 Issue 3, p632-640, 9p, 1 Diagram, 5 Charts |
| مصطلحات موضوعية: |
ANTI-infective agents, ANTIBIOTICS, AUTOGRAFTS, CLOSTRIDIUM diseases, CONVALESCENCE, ETIOLOGY of diseases, DRUG utilization, FEBRILE neutropenia, FEVER, HEMATOPOIETIC stem cell transplantation, LONGITUDINAL method, TRANSPLANTATION of organs, tissues, etc., RETROSPECTIVE studies, DESCRIPTIVE statistics, ODDS ratio, ADULTS |
| مستخلص: |
Background: The optimal duration of empiric antimicrobial therapy in febrile neutropenia of unknown origin is unclear. This study evaluated outcomes in autologous and allogeneic hematopoietic cell transplantation recipients with febrile neutropenia of unknown origin who received early de-escalation of broad-spectrum antimicrobials prior to hematopoietic recovery versus those who continued broad-spectrum antimicrobials until hematopoietic recovery. Methods: A single-center, retrospective study assessed hematopoietic cell transplantation recipients with febrile neutropenia of unknown origin. Patients were categorized into either cohort 1, representing early de-escalation prior to hematopoietic recovery, or cohort 2, representing continuation of broad-spectrum antimicrobials until hematopoietic recovery. Results: A total of 107 patients were included (22.4% in cohort 1 and 77.6% in cohort 2). Most patients (87.5%) in cohort 1 underwent haploidentical hematopoietic cell transplantation, whereas 84.3% of patients in cohort 2 received autologous hematopoietic cell transplantation. There were no significant differences in rates of recurrent fever (4.2% versus 7.2%, in cohorts 1 and 2, respectively, adjusted odds ratio = 0.84, P = 0.85), re-escalation (4.2% versus 4.8%, adjusted odds ratio = 1.57, P = 0.64), and Clostridioides difficile -associated infections (4.2% versus 2.4%, adjusted odds ratio = 2.27, P = 0.43). No patient experienced in-hospital mortality, intensive care unit admission, or bacteremia. Conclusion: Hematopoietic cell transplantation recipients with febrile neutropenia of unknown origin in which broad-spectrum antimicrobials were de-escalated prior to hematopoietic recovery did not experience adverse outcomes. These results concur with recently published studies and the Fourth European Conference on Infections in Leukemia guidelines. An early de-escalation approach in haploidentical hematopoietic cell transplantation recipients specifically appears safe and may result in a reduction in antimicrobial utilization. [ABSTRACT FROM AUTHOR] |
|
Copyright of Journal of Oncology Pharmacy Practice is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) |
| قاعدة البيانات: |
Complementary Index |
