OBJECTIVES: This study was initiated to determine the local profile of blood culture isolates and antibiotic sensitivities in febrile neutropenic patients following chemotherapy, and to establish if any modifications to treatment guidelines are necessary. DESIGN: A total of 116 episodes of febrile neutropenia admitted to the adult hematology ward at a university medical center in Malaysia were studied retrospectively from January 2004 to January 2005. RESULTS: The study showed 43.1% of febrile neutropenic episodes had established bacteremia. Gram-negative bacteria accounted for 60.3% of isolates. Sensitivities of Gram-negative bacteria to the antibiotics recommended in the Infectious Diseases Society of America (IDSA) guidelines were 86.1-97.2%. Coagulase-negative staphylococci were the most common Gram-positive organisms isolated (23.3%). The majority of these were methicillin-resistant. CONCLUSIONS: Carbapenem monotherapy, as recommended in the 2002 IDSA guidelines, is effective treatment for the infections most often encountered at our center. Combination therapy with an aminoglycoside should be considered when using ceftazidime, cefepime or piperacillin-tazobactam, particularly in high-risk patients. Vancomycin should be used if a Gram-positive organism is suspected or isolated.
OBJECTIVES: This study was initiated to determine the local profile of blood culture isolates and antibiotic sensitivities in febrile neutropenicpatients following chemotherapy, and to establish if any modifications to treatment guidelines are necessary. DESIGN: A total of 116 episodes of febrile neutropenia admitted to the adult hematology ward at a university medical center in Malaysia were studied retrospectively from January 2004 to January 2005. RESULTS: The study showed 43.1% of febrile neutropenic episodes had established bacteremia. Gram-negative bacteria accounted for 60.3% of isolates. Sensitivities of Gram-negative bacteria to the antibiotics recommended in the Infectious Diseases Society of America (IDSA) guidelines were 86.1-97.2%. Coagulase-negative staphylococci were the most common Gram-positive organisms isolated (23.3%). The majority of these were methicillin-resistant. CONCLUSIONS:Carbapenem monotherapy, as recommended in the 2002 IDSA guidelines, is effective treatment for the infections most often encountered at our center. Combination therapy with an aminoglycoside should be considered when using ceftazidime, cefepime or piperacillin-tazobactam, particularly in high-risk patients. Vancomycin should be used if a Gram-positive organism is suspected or isolated.
Authors: Fekade Bruck Sime; Uwe Hahn; Morgyn S Warner; Ing Soo Tiong; Michael S Roberts; Jeffrey Lipman; Sandra L Peake; Jason A Roberts Journal: Antimicrob Agents Chemother Date: 2017-10-24 Impact factor: 5.191
Authors: Shin Ahn; Yoon-Seon Lee; Yun-Hee Chun; In-Ho Kwon; Won Kim; Kyung Soo Lim; Tae Won Kim; Kyoo-Hyung Lee Journal: Support Care Cancer Date: 2010-06-16 Impact factor: 3.603
Authors: Arun B Karanwal; Bharat J Parikh; Parijat Goswami; Harsha P Panchal; Bhavesh B Parekh; Kaushal B Patel Journal: Indian J Med Paediatr Oncol Date: 2013-04