Antimicrobial Stewardship on Patients with Neutropenia: A Narrative Review Commissioned by Microorganisms
The emergence of antibiotic resistance poses a global health threat. High-risk patients such as those with neutropenia are particularly vulnerable to opportunistic infections, sepsis, and multidrug-resistant infections, and clinical outcomes remain the primary concern. Antimicrobial stewardship (AMS...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-04-01
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| Series: | Microorganisms |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2076-2607/11/5/1127 |
| _version_ | 1797598998882680832 |
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| author | Joana Alves Betânia Abreu Pedro Palma Emine Alp Tarsila Vieceli Jordi Rello |
| author_facet | Joana Alves Betânia Abreu Pedro Palma Emine Alp Tarsila Vieceli Jordi Rello |
| author_sort | Joana Alves |
| collection | DOAJ |
| description | The emergence of antibiotic resistance poses a global health threat. High-risk patients such as those with neutropenia are particularly vulnerable to opportunistic infections, sepsis, and multidrug-resistant infections, and clinical outcomes remain the primary concern. Antimicrobial stewardship (AMS) programs should mainly focus on optimizing antibiotic use, decreasing adverse effects, and improving patient outcomes. There is a limited number of published studies assessing the impact of AMS programs on patients with neutropenia, where early appropriate antibiotic choice can be the difference between life and death. This narrative review updates the current advances in strategies of AMS for bacterial infections among high-risk patients with neutropenia. Diagnosis, drug, dose, duration, and de-escalation (5D) are the core variables among AMS strategies. Altered volumes of distribution can make standard dose regimens inadequate, and developing skills towards a personalized approach represents a major advance in therapy. Intensivists should partner antibiotic stewardship programs to improve patient care. Assembling multidisciplinary teams with trained and dedicated professionals for AMS is a priority. |
| first_indexed | 2024-03-11T03:28:32Z |
| format | Article |
| id | doaj.art-8e2851de0e404101b2fd8fc93bace6de |
| institution | Directory Open Access Journal |
| issn | 2076-2607 |
| language | English |
| last_indexed | 2024-03-11T03:28:32Z |
| publishDate | 2023-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Microorganisms |
| spelling | doaj.art-8e2851de0e404101b2fd8fc93bace6de2023-11-18T02:32:13ZengMDPI AGMicroorganisms2076-26072023-04-01115112710.3390/microorganisms11051127Antimicrobial Stewardship on Patients with Neutropenia: A Narrative Review Commissioned by MicroorganismsJoana Alves0Betânia Abreu1Pedro Palma2Emine Alp3Tarsila Vieceli4Jordi Rello5Infectious Diseases Department, Hospital de Braga, 4710-243 Braga, PortugalPharmaceuticals Department, Hospital de Braga, 4710-243 Braga, PortugalInfectious Diseases Department, Centro Hospitalar do Tâmega e Sousa, 4564-007 Penafiel, PortugalInfectious Diseases and Clinical Microbiology Department, Ankara Yıldırım Beyazıt University, 06760 Ankara, TurkeyInfectious Diseases Department, Hospital de Clínicas de Porto Alegre, Porto Alegre 90035-903, BrazilClinical Research in Pneumonia & Sepsis (CRIPS), Vall d’Hebron Institute of Research (VHIR), 08035 Barcelona, SpainThe emergence of antibiotic resistance poses a global health threat. High-risk patients such as those with neutropenia are particularly vulnerable to opportunistic infections, sepsis, and multidrug-resistant infections, and clinical outcomes remain the primary concern. Antimicrobial stewardship (AMS) programs should mainly focus on optimizing antibiotic use, decreasing adverse effects, and improving patient outcomes. There is a limited number of published studies assessing the impact of AMS programs on patients with neutropenia, where early appropriate antibiotic choice can be the difference between life and death. This narrative review updates the current advances in strategies of AMS for bacterial infections among high-risk patients with neutropenia. Diagnosis, drug, dose, duration, and de-escalation (5D) are the core variables among AMS strategies. Altered volumes of distribution can make standard dose regimens inadequate, and developing skills towards a personalized approach represents a major advance in therapy. Intensivists should partner antibiotic stewardship programs to improve patient care. Assembling multidisciplinary teams with trained and dedicated professionals for AMS is a priority.https://www.mdpi.com/2076-2607/11/5/1127immunocompromised patientsantimicrobial prescription optimizationcritically ill patientsappropriate antibioticantibiotic dose adjustment |
| spellingShingle | Joana Alves Betânia Abreu Pedro Palma Emine Alp Tarsila Vieceli Jordi Rello Antimicrobial Stewardship on Patients with Neutropenia: A Narrative Review Commissioned by Microorganisms Microorganisms immunocompromised patients antimicrobial prescription optimization critically ill patients appropriate antibiotic antibiotic dose adjustment |
| title | Antimicrobial Stewardship on Patients with Neutropenia: A Narrative Review Commissioned by Microorganisms |
| title_full | Antimicrobial Stewardship on Patients with Neutropenia: A Narrative Review Commissioned by Microorganisms |
| title_fullStr | Antimicrobial Stewardship on Patients with Neutropenia: A Narrative Review Commissioned by Microorganisms |
| title_full_unstemmed | Antimicrobial Stewardship on Patients with Neutropenia: A Narrative Review Commissioned by Microorganisms |
| title_short | Antimicrobial Stewardship on Patients with Neutropenia: A Narrative Review Commissioned by Microorganisms |
| title_sort | antimicrobial stewardship on patients with neutropenia a narrative review commissioned by microorganisms |
| topic | immunocompromised patients antimicrobial prescription optimization critically ill patients appropriate antibiotic antibiotic dose adjustment |
| url | https://www.mdpi.com/2076-2607/11/5/1127 |
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