The Evaluation of Febrile Neutropenic Episodes in Patients with Hematologic Malignancies
Infections remain the major cause of morbidity and mortality among neutropenic patients with hematologic malignancies. As the delay of antibiotic treatment in such patients increases mortalility, it is necessary, after clinical and microbiological assessment and physical examination, to administer e...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Bilimsel Tip Yayinevi
2007-06-01
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| Series: | Flora Infeksiyon Hastalıkları ve Klinik Mikrobiyoloji Dergisi |
| Subjects: | |
| Online Access: | http://www.floradergisi.org/getFileContent.aspx?op=REDPDF&file_name=2007-12-2-080-085.pdf |
| Summary: | Infections remain the major cause of morbidity and mortality among neutropenic patients with hematologic malignancies. As the delay of antibiotic treatment in such patients increases mortalility, it is necessary, after clinical and microbiological assessment and physical examination, to administer empirical antimicrobial agents. The antibiotic must be with high dosage, wide spectrum and bactericidal effect. One hundred thirty three consecutive neutropenic patients with hematologic malignancies were admitted to the Department of Hematology of Karadeniz Technical University Faculty of Medicine between March 2003 and November 2005. A total of 217 febrile neutropenic episodes were treated; 102 febrile episodes with piperacilline-tazobactam plus amikacin, and 91 episodes with cefepime plus amikacin were treated. Microscopically documented infections were found in 18.4%, other clinically documented infections in 27.6%, and fever of unknown origin in 53.9% of the febrile episodes. Piperacilline-tazobactam plus amikacin was successful in 43 of 102 episodes (42.1%), and cefepime plus amikacin was successful in 46 of 91 episodes (50.5%). After modifications, piperacilline-tazobactam plus amikacin success rate was 90.1%, cefepime plus amikacin success rate was 85.7%. The empirical regimen of cefepime plus amikacin was equivalent to piperacillin-tazobactam plus amikacin in febrile adult hematology patients with severe neutropenia (p= 0.266). |
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| ISSN: | 1300-932X 1300-932X |