Febrile Neutropenia in Hematological Malignancies: Clinical and Microbiological Profile and Outcome in High Risk Patients
Background and Objectives: Febrile neutropenia (FN) is considered a medical emergency. Patients with hematological malignancies (HM) commonly experience FN. Broad spectrum antibiotics have to be started empirically to prevent complications. This study depicts the clinical profile, microbiological pr...
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| Format: | Article |
| Language: | English |
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Thieme Medical and Scientific Publishers Pvt. Ltd.
2015-07-01
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| Series: | Journal of Laboratory Physicians |
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| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.4103/0974-2727.163126 |
| _version_ | 1811339624508817408 |
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| author | Kuntegowdanahalli C Lakshmaiah Abhayakumar S Malabagi Rachan Shetty Mahua Sinha Rudrapatna S Jayashree |
| author_facet | Kuntegowdanahalli C Lakshmaiah Abhayakumar S Malabagi Rachan Shetty Mahua Sinha Rudrapatna S Jayashree |
| author_sort | Kuntegowdanahalli C Lakshmaiah |
| collection | DOAJ |
| description | Background and Objectives: Febrile neutropenia (FN) is considered a medical emergency. Patients with hematological malignancies (HM) commonly experience FN. Broad spectrum antibiotics have to be started empirically to prevent complications. This study depicts the clinical profile, microbiological profile, antibiotic sensitivity pattern, and outcome in high risk HM.
Materials and Methods: In this prospective study, 72 patients with hematologic malignancies, diagnosed and treated for 108 high risk febrile neutropenic episodes from August 2011 to January 2013 at a Regional Cancer Center, in South India were analyzed. Cefoperazone-sulbactum was used as a first-line empiric antibiotic.
Results: Majority of the patients with FN episodes had acute myeloid leukemia. Overall culture positivity was 29.62%. The most common organisms isolated were Gram-negative bacilli (63.64%), with Escherichia coli being the most frequent pathogen. All Gram-negative organisms were sensitive to imipenem, whereas sensitivity pattern to other antibiotics were as follows: 85.71%, 78.26%, 69.52%, 63.64%, 41.66% and 47.05% for pipercillin-tazoactum, meropenem, cefoperazone-sulbactum, amikacin, ceftazidime, ciprofloxacin respectively. Overall mortality was 13.5%. Most of the patients responded to empiric antibiotic cefoperazone-sulbactum.
Conclusions: In the hematologic malignancies particularly in acute leukemia, there is high risk of developing FN. Empiric therapy with cefoperazone-sulbactum as a first line leads to satisfactory outcome in high risk FN and therapy should be tailored to the most appropriate antibiotics according to the bacterial culture results. |
| first_indexed | 2024-04-13T18:29:39Z |
| format | Article |
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| institution | Directory Open Access Journal |
| issn | 0974-2727 0974-7826 |
| language | English |
| last_indexed | 2024-04-13T18:29:39Z |
| publishDate | 2015-07-01 |
| publisher | Thieme Medical and Scientific Publishers Pvt. Ltd. |
| record_format | Article |
| series | Journal of Laboratory Physicians |
| spelling | doaj.art-88ae45674b1645e7b197080eac4ce8642022-12-22T02:35:08ZengThieme Medical and Scientific Publishers Pvt. Ltd.Journal of Laboratory Physicians0974-27270974-78262015-07-0170211612010.4103/0974-2727.163126Febrile Neutropenia in Hematological Malignancies: Clinical and Microbiological Profile and Outcome in High Risk PatientsKuntegowdanahalli C Lakshmaiah0Abhayakumar S Malabagi1Rachan Shetty2Mahua Sinha3Rudrapatna S Jayashree4Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, IndiaDepartment of Medical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, IndiaDepartment of Medical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, IndiaDepartment of Microbiology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, IndiaDepartment of Microbiology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, IndiaBackground and Objectives: Febrile neutropenia (FN) is considered a medical emergency. Patients with hematological malignancies (HM) commonly experience FN. Broad spectrum antibiotics have to be started empirically to prevent complications. This study depicts the clinical profile, microbiological profile, antibiotic sensitivity pattern, and outcome in high risk HM. Materials and Methods: In this prospective study, 72 patients with hematologic malignancies, diagnosed and treated for 108 high risk febrile neutropenic episodes from August 2011 to January 2013 at a Regional Cancer Center, in South India were analyzed. Cefoperazone-sulbactum was used as a first-line empiric antibiotic. Results: Majority of the patients with FN episodes had acute myeloid leukemia. Overall culture positivity was 29.62%. The most common organisms isolated were Gram-negative bacilli (63.64%), with Escherichia coli being the most frequent pathogen. All Gram-negative organisms were sensitive to imipenem, whereas sensitivity pattern to other antibiotics were as follows: 85.71%, 78.26%, 69.52%, 63.64%, 41.66% and 47.05% for pipercillin-tazoactum, meropenem, cefoperazone-sulbactum, amikacin, ceftazidime, ciprofloxacin respectively. Overall mortality was 13.5%. Most of the patients responded to empiric antibiotic cefoperazone-sulbactum. Conclusions: In the hematologic malignancies particularly in acute leukemia, there is high risk of developing FN. Empiric therapy with cefoperazone-sulbactum as a first line leads to satisfactory outcome in high risk FN and therapy should be tailored to the most appropriate antibiotics according to the bacterial culture results.http://www.thieme-connect.de/DOI/DOI?10.4103/0974-2727.163126antibioticsfebrile neutropeniagram-negative organismhematological malignanciestreatment |
| spellingShingle | Kuntegowdanahalli C Lakshmaiah Abhayakumar S Malabagi Rachan Shetty Mahua Sinha Rudrapatna S Jayashree Febrile Neutropenia in Hematological Malignancies: Clinical and Microbiological Profile and Outcome in High Risk Patients Journal of Laboratory Physicians antibiotics febrile neutropenia gram-negative organism hematological malignancies treatment |
| title | Febrile Neutropenia in Hematological Malignancies: Clinical and Microbiological Profile and Outcome in High Risk Patients |
| title_full | Febrile Neutropenia in Hematological Malignancies: Clinical and Microbiological Profile and Outcome in High Risk Patients |
| title_fullStr | Febrile Neutropenia in Hematological Malignancies: Clinical and Microbiological Profile and Outcome in High Risk Patients |
| title_full_unstemmed | Febrile Neutropenia in Hematological Malignancies: Clinical and Microbiological Profile and Outcome in High Risk Patients |
| title_short | Febrile Neutropenia in Hematological Malignancies: Clinical and Microbiological Profile and Outcome in High Risk Patients |
| title_sort | febrile neutropenia in hematological malignancies clinical and microbiological profile and outcome in high risk patients |
| topic | antibiotics febrile neutropenia gram-negative organism hematological malignancies treatment |
| url | http://www.thieme-connect.de/DOI/DOI?10.4103/0974-2727.163126 |
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