Weihua Zhai1, Xiaoyu Zhang2, Jialin Wei3, Qi Deng4, Xiaoyuan Dong5, Xiaolei Zhang6, Guixin Zhang7, Qiaoling Ma8, Rongli Zhang9, Dong Su10, Sizhou Feng11, Mingzhe Han12. 1. Institute of Hematology and Blood Diseases Hospital, CAMS and PUMC, Tianjin, China. Electronic address: zhaiweihua@eyou.com. 2. Institute of Hematology and Blood Diseases Hospital, CAMS and PUMC, Tianjin, China. Electronic address: lovingyvonne@163.com. 3. Institute of Hematology and Blood Diseases Hospital, CAMS and PUMC, Tianjin, China. Electronic address: katewjl@medmail.com.cn. 4. Department of hematology, the first center hospital of Tianjin. Electronic address: kachydeng@hotmail.com. 5. Department of hematology, affiliated Qilu hospital of Shandong medical school. Electronic address: sdsgr@sina.com. 6. Department of hematology, the second affiliated hospital of Hebei medical school. Electronic address: xiaoleixueye@126.com. 7. Institute of Hematology and Blood Diseases Hospital, CAMS and PUMC, Tianjin, China. Electronic address: zoexin@126.com. 8. Institute of Hematology and Blood Diseases Hospital, CAMS and PUMC, Tianjin, China. Electronic address: maqiaoling88@126.com. 9. Institute of Hematology and Blood Diseases Hospital, CAMS and PUMC, Tianjin, China. Electronic address: zhangeongli333@sina.com. 10. Institute of Hematology and Blood Diseases Hospital, CAMS and PUMC, Tianjin, China. Electronic address: sudong1026@126.com. 11. Institute of Hematology and Blood Diseases Hospital, CAMS and PUMC, Tianjin, China. Electronic address: sizhoufeng@medmail.com.cn. 12. Institute of Hematology and Blood Diseases Hospital, CAMS and PUMC, Tianjin, China. Electronic address: mzhan@medmail.com.cn.
Abstract
OBJECTIVES: Febrile neutropenia (FN) is a common but lethal complication of chemotherapy in hematological malignance. The aim of this study was to identify the prognostic risk factors for antibiotic treatment outcome in PN patients, and provide the optimal choice for the initial empirical antibiotic treatment. METHODS: 227 consecutive FN hematologic malignancies from four hospitals in Northeast China were enrolled. The outcome of antibiotic therapy was investigated until 14 days after the onset of FN. The factors affecting antibiotic therapy outcome were evaluated using Univariate analysis and Multivariate logistic regression analysis. RESULTS: Among all patients, 27 patients did not achieve favorable outcome either clinically or bacteriologically. It was shown that the risk factors for poor FN therapy outcome were associated with prolonged duration of neutropenia over 9 days during FN (P=0.019), slow neutrophil recovery (P=0.039), respiratory infection (P=0.005), and that initial monotherapy with drugs recommended by the guidelines indicated better outcome (P=0.009). Additionally, patients with multi-bacterial infection, as well as further ANC decrease after fever, had a poor prognosis. CONCLUSIONS: Our results indicate that early application of antibiotics and prevention of respiratory infection as well as good clinical care are able to improve clinical outcomes from empirical antibiotic treatment in FN patients with hematological malignances.
OBJECTIVES:Febrile neutropenia (FN) is a common but lethal complication of chemotherapy in hematological malignance. The aim of this study was to identify the prognostic risk factors for antibiotic treatment outcome in PNpatients, and provide the optimal choice for the initial empirical antibiotic treatment. METHODS: 227 consecutive FN hematologic malignancies from four hospitals in Northeast China were enrolled. The outcome of antibiotic therapy was investigated until 14 days after the onset of FN. The factors affecting antibiotic therapy outcome were evaluated using Univariate analysis and Multivariate logistic regression analysis. RESULTS: Among all patients, 27 patients did not achieve favorable outcome either clinically or bacteriologically. It was shown that the risk factors for poor FN therapy outcome were associated with prolonged duration of neutropenia over 9 days during FN (P=0.019), slow neutrophil recovery (P=0.039), respiratory infection (P=0.005), and that initial monotherapy with drugs recommended by the guidelines indicated better outcome (P=0.009). Additionally, patients with multi-bacterial infection, as well as further ANC decrease after fever, had a poor prognosis. CONCLUSIONS: Our results indicate that early application of antibiotics and prevention of respiratory infection as well as good clinical care are able to improve clinical outcomes from empirical antibiotic treatment in FN patients with hematological malignances.
Authors: Inês Rodrigues; Luísa Nascimento; Ana Cláudia Pimenta; Sara Raimundo; Bebiana Conde; Ana Fernandes Journal: Zhongguo Fei Ai Za Zhi Date: 2021-11-20