Clinical impact of a change in antibiotics or the addition of glycopeptide antibiotics for persistent febrile neutropenia after autologous stem cell transplantation.

Autor:	Yoshino N; Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama, Japan., Kimura SI; Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama, Japan., Kawamura K; Division of Clinical Laboratory Medicine, Department of Multidisciplinary Internal Medicine, Faculty of Medicine, Tottori University, Yonago, Japan., Nakata Y; Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama, Japan., Matsuoka A; Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama, Japan., Ishikawa T; Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama, Japan., Meno T; Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama, Japan., Nakamura Y; Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama, Japan., Kawamura M; Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama, Japan., Kawamura S; Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama, Japan., Takeshita J; Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama, Japan., Misaki Y; Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama, Japan., Yoshimura K; Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama, Japan., Gomyo A; Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama, Japan., Okada Y; Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama, Japan., Tamaki M; Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama, Japan., Kusuda M; Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama, Japan., Kameda K; Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama, Japan., Akahoshi Y; Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama, Japan., Sato M; Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama, Japan., Tanihara A; Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama, Japan., Nakasone H; Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama, Japan., Kako S; Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama, Japan., Kanda Y; Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama, Japan; Division of Hematology, Department of Medicine, Jichi Medical University, Shimotsuke, Japan. Electronic address: ycanda-tky@umin.ac.jp.
Jazyk:	angličtina
Zdroj:	Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy [J Infect Chemother] 2024 Jun 24. Date of Electronic Publication: 2024 Jun 24.
DOI:	10.1016/j.jiac.2024.06.018
Abstrakt:	Background: A change in empirical antibiotics or the addition of glycopeptide antibiotics is often applied in cases of persistent febrile neutropenia (FN) despite the administration of broad-spectrum antibiotics. However, the clinical benefit of these approaches remains unclear. Methods: We conducted a retrospective study to evaluate the effectiveness of a change in antibiotics or the addition of glycopeptide antibiotics for persistent FN after autologous hematopoietic cell transplantation (auto-HCT). We retrospectively reviewed the records of 208 patients who received auto-HCT at our institution between 2007 and 2019. FN that lasted for 4 days or longer was defined as persistent FN. We compared the time to defervescence between patients whose initial antibiotics were changed and/or who additionally received glycopeptide antibiotics, and those without these antibiotic modifications. Results: Among patients who fulfilled the criteria of persistent FN (n = 125), changes in antibiotics were not significantly associated with the time to defervescence in a multivariate analysis (hazard ratio [HR] 0.72, p = 0.27). On the other hand, the addition of glycopeptide antibiotics was paradoxically associated with a delay in defervescence (HR 0.56, p = 0.033). Conclusions: Although there may be differences in patient backgrounds, no significant differences were observed in either a univariate or multivariate analysis. Since neither a change in antibiotics nor the addition of glycopeptide antibiotics was associated with earlier defervescence in persistent FN after auto-HCT, routine antibiotic modifications might not be necessary in this setting. Competing Interests: Declaration of competing interest The authors have no potential conflicts of interest to disclose. (Copyright © 2024 Japanese Society of Chemotherapy, Japanese Association for Infectious Diseases, and Japanese Society for Infection Prevention and Control. Published by Elsevier Ltd. All rights reserved.)
Databáze:	MEDLINE
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