medigraphic.com

2019, Number 4

<< Back Next >>

Rev Hematol Mex 2019; 20 (4)

Therapeutic success of empirical antibiotic in febrile neutropenia due to acute leukemia remission induction chemotherapy

Gómez-Ochoa G, García-Méndez S, Hernández-Ruiz E

Language: Spanish
References: 29
Page: 247-254
PDF size: 356.32 Kb.


ABSTRACT

Background: Febrile neutropenia is a frequent complication of acute leukemia remission induction chemotherapy (ALRICh).
Objective: To quantify the therapeutic success of the empirical antimicrobial regimens used in the treatment of high-risk febrile neutropenia and, secondarily, to identify the variables that correlate with this outcome.
Material and Method: An observational, analytical and retrospective study was done evaluating the files of patients who developed high-risk febrile neutropenia after ALRICh from January 2007 to December 2014 at High Specialty Regional Hospital of Oaxaca, Mexico. Demographic, associated with leukemia, febrile neutropenia and treatment variables were measured. A descriptive statistical analysis and Spearman correlation was done.
Results: Forty-two records of patients diagnosed with acute leukemia were included. The therapeutic success occurred in 93% of the patients, ceftazidime/ amikacin (43%) and imipenem (41%) were the most prescribed antimicrobials and the therapeutic success was similar for both antibiotics (88 and 95%, respectively). Bacterial infection was documented in 20 patients (47.6%). There were significant correlations (p ‹ 0.05) with the delay of onset and with the escalation of treatment for treatment failure.
Conclusions: The global and categorized therapeutic success by antimicrobial regimen was similar to that reported in the literature. Delayed onset and therapeutic staging correlate negatively with therapeutic success.


REFERENCES

  1. Lyman GH, Kuderer NM, Crawford J, et al. Predicting individual risk of neutropenic complications in patients receiving cancer chemotherapy. Cancer 2011:117(9):1917-27. doi: 10.1002/cncr.25691.

  2. Keng MK, Sekeres MA. Febrile neutropenia in hematologic malignancies. Curr Hematol Malig Rep 2013;8(4):370-8. doi: 10.1007/s11899-013-0171-4.

  3. White L, Ybarra M. Neutropenic fever. Emerg Med Clin North Am 2014;32(3):549-61. doi: 10.1016/j.emc.2014.04.002.

  4. Bodey GP, Buckley M, Sathe YS, Freireich EJ. Quantitative relationships between circulating leukocytes and infection in patients with acute leukemia. Ann Intern Med 1966;64(2):328-40.

  5. Rosenberg PS, Alter BP, Bolyard AA, et al. Severe Chronic Neutropenia International Registry. The incidence of leukemia and mortality from sepsis in patients with severe congenital neutropenia receiving long-term G-CSF therapy. Blood 2006;107(12):4628-35. DOI: 10.1182/ blood-2005-11-4370.

  6. Ramphal R. Changes in the etiology of bacteremia in febrile neutropenic patients and the susceptibilities of the currently isolated pathogens. Clin Infect Dis 2004;39(Suppl 1):S25-31. DOI: 10.1086/383048.

  7. Feld R, DePauw B, Berman S, Keating A, Ho W. Meropenem versus cefepime in the treatment of cancer patients with febrile neutropenia: a randomized, double-blind trial. J Clin Oncol 2000;18(21):3690-8. DOI: 10.1200/ JCO.2000.18.21.3690.

  8. Raad II, Escalante C, Hachem RY, et al. Treatment of febrile neutropenic patients with cancer who require hospitalization: a prospective randomized study comparing imipenem and cefepime. Cancer 2003;98(5):1039-47. DOI: 10.1002/ cncr.11613.

  9. Yahav D, Paul M, Fraser A, Sarid N, Leibovici L. Efficacy and safety of cefepime: a systematic review and meta-analysis. Lancet Infect Dis 2007;7(5):338-48. DOI: 10.1016/S1473- 3099(07)70109-3.

  10. Furno P, Bucaneve G, del Favero A. Monotherapy or aminoglycoside- containing combinations for empirical antibiotic treatment of febrile neutropenic patients: a meta-analysis. Lancet Infect Dis. 2002;2(4):231-42.

  11. Paul M, Dickstein Y, Schlesinger A, Gronzinsky-Glasberg S, Soares-Weiser K, Leibovici L. Beta-lactam versus betalactam- aminoglycoside combination therapy in cancer patients with neutropenia. Cochrane Database Syst Rev 2013;(6):CD003038.

  12. Paul M, Soares-Weiser K, Leibovici L. B-lactam monotherapy versus b-lactam-aminoglycoside combination therapy for fever with neutropenia: systematic review and meta-analysis. BMJ. 2003;326(7399):1111. DOI: 10.1136/ bmj.326.7399.1111.

  13. Masmoudi S, Khanfir A, Maalej-Mezghan S, Hammami A, Frikha M. Chemotherapy-induced febrile neutropenia: About 186 episodes. Clinical, microbiological and therapeutic characteristics. Tunis Med 2015;93(4):217-22.

  14. Dompeling EC, Donnelly JP, Deresinski SC, Feld R, Lane- Allman EF, De Pauw BE. Early identification of neutropenic patients at risk of grampositive bacteraemia and the impact of empirical administration of vancomycin. Eur J Cancer 1996;32A(8):1332-9. DOI: 10.1016/0959-8049(96)00050-0.

  15. De Pauw B, Walsh TJ, Donnelly JP, et al. Revised definitions of invasive fungal disease from the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG) Consensus Group. Clin Infect Dis 2008;46(12):1813-21. doi: 10.1086/588660.

  16. Walsh TJ, Teppler H, Donowitz GR, et al. Caspofungin versus liposomal amphotericin B for empirical antifungal therapy in patients with persistent fever and neutropenia. N Engl J Med 2004;351(14):1391-402. DOI: 10.1056/NEJMoa040446.

  17. Alvarado-Ibarra M, Báez-Islas P, López-Hernández M. High risk febrile neutropenia: success rate of antibiotic schemes used in hematology department. Int J Current Research 2016;8(11):41247-52.

  18. Lyman GH. A comparison of international guidelines for the prevention of chemotherapy-induced neutropenia. Curr Opin Hematol 2011;18(1):1-10. doi: 10.1097/ MOH.0b013e328340dc51.

  19. Ahn S, Lee YS, Chun YH, et al. Predictive factors of poor prognosis in cancer patients with chemotherapy-induced febrile neutropenia. Support Care Cancer 2011;19(8):1151- 8. doi: 10.1007/s00520-010-0928-4.

  20. Klastersky J, Paesmans M, Rubenstein EB, et al. The Multinational Association for Supportive Care in Cancer risk index: A multinational scoring system for identifying low-risk febrile neutropenic cancer patients. J Clin Oncol 2000;18(16):3038-51. DOI: 10.1200/ JCO.2000.18.16.3038.

  21. Bryant AL, Deal AM, Walton A, Wood WA, Muss H, Mayer DK. Use of ED and hospital services for patients with acute leukemia after induction therapy: one year follow-up. Leuk Res 2015;39(4):406-10. doi: 10.1016/j. leukres.2015.01.006.

  22. Freifeld AG, Bow EJ, Sepkowitz KA, et al. Infectious Diseases Society of America. Clinical practice guideline for the use of antimicrobial agents in neutropenic patients with cancer: 2010 update by the Infectious Diseases Society of America. Clin Infect Dis 2011;52(4):e56-93. doi: 10.1093/cid/cir073.

  23. Klastersky J, de Naurois J, Rolston K, et al. ESMO Guidelines Committee. Management of febrile neutropaenia: ESMO Clinical Practice Guidelines. Ann Oncol 2016;27(suppl 5):v111-v118. https://doi.org/10.1093/ annonc/mdw325.

  24. Averbuch D, Orasch C, Cordonnier C, et al. European guidelines for empirical antibacterial therapy for febrile neutropenic patients in the era of growing resistance: summary of the 2011 4th European Conference on Infections in Leukemia. Haematologica 2013;98(12)1826-35. doi: 10.3324/haematol.2013.091025.

  25. Flowers CR, Seidenfeld J, Bow EJ, et al. Antimicrobial prophylaxis and outpatient management of fever and neutropenia in adults treated for malignancy: American Society of Clinical Oncology clinical practice guideline. J Clin Oncol 2013;31(6):794-810. doi: 10.1200/JCO.2012.45.8661.

  26. Baden LR, Bensinger W, Angarone M, et al. Prevention and treatment of cancer-related infections. J Natl Compr Canc Netw 2012;10(11):1412-45. DOI: https://doi.org/10.6004/ jnccn.2016.0093

  27. Rivas-Llamas R, Best-Aguilera C, Fernández-Figueroa YM, y col. Consenso mexicano para el abordaje diagnóstico y terapéutico del paciente con neutropenia febril. Rev Hematol Mex 2014;15(Supl 2):S207-S268.

  28. Rosa RG, Goldani LZ. Cohort study of the impact of time to antibiotic administration on mortality in patients with febrile neutropenia. Antimicrob Agents Chemother 2014;58(7):3799-803. doi: 10.1128/AAC.02561-14.

  29. Moghnieh R, Estaitieh N, Mugharbil A, et al. Third generation cephalosporin resistant Enterobacteriaceae and multidrug resistant gram-negative bacteria causing bacteremia in febrile neutropenia adult cancer patients in Lebanon, broad spectrum antibiotics use as a major risk factor, and correlation with poor prognosis. Front Cell Infect Microbiol. 2015;5:11. doi: 10.3389/fcimb.2015.00011.




2020     |     www.medigraphic.com