Management of febrile neutropenia in solid organ malignancies following chemotherapy
| Autor: | R.S. Jayashree, Rachan Shetty, S M Abhayakumar, K. Govindbabu, Kuntegowdanahalli C Lakshmaiah, D Loknath |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2014 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent medicine.drug_class Antibiotics Microbial Sensitivity Tests Meropenem lcsh:RC254-282 solid malignancies chemistry.chemical_compound Young Adult Risk Factors Cefoperazone-sulbactum Internal medicine Neoplasms Antineoplastic Combined Chemotherapy Protocols medicine Humans Radiology Nuclear Medicine and imaging Intensive care medicine Aged Febrile Neutropenia Teicoplanin business.industry E. coli Disease Management General Medicine solid organ malignancies Middle Aged medicine.disease lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens Anti-Bacterial Agents Treatment Outcome Oncology chemistry Amikacin Linezolid Vancomycin Female febrile neutropenias business Febrile neutropenia medicine.drug Piperacillin |
| Zdroj: | Journal of Cancer Research and Therapeutics, Vol 10, Iss 3, Pp 540-543 (2014) |
| ISSN: | 1998-4138 0973-1482 |
| Popis: | Background: Febrile neutropenia is a medical emergency and it requires immediate hospitalization for evaluation and administration of empiric broad-spectrum antibiotics. The present study was undertaken to analyze the infectious agents, choice of empiric antibiotics, and outcome in high-risk febrile neutropenia in the solid organ malignancies. Materials and Methods: In this study, 92 high risk febrile neutropenic episodes were analyzed in 72 patients with solid organ malignancies. We used cefoperazone-sulbactum as an initial empiric antibiotic. Piperacillin/tazobactum or carbapenems were added to the patients who did not respond to initial antibiotic. Results: Among the 92 episodes treated, most patients received first-line chemotherapy for locally advanced disease. Microbes were isolated in 25% of febrile neutropenic episodes. Gram-negative organism (61.70%) constituted the most common isolates. The most common microbes identified were E. coli and Staphylococcus aureus in blood, Klebsiella pneumonia in sputum and E. coli in urine culture. Patients who had been treated with cefoperazone-sulbactum improved clinically in 70.6% of febrile neutropenic episodes. Second- line antibiotics (piperacillin-tazobactum with amikacin) were required in 24% episodes, while another 5.4% episodes required third-line antibiotics (carbapenems). In this study, mortality was seen in 12% of febrile neutropenic episodes. Staphylococcus aureus was 100% sensitive to linezolid, teicoplanin, and vancomycin, whereas Gram-negative organisms were 100% sensitive to imepenem and meropenem. Conclusion: Cephaperazone-sulbactum is a reasonable initial choice for empirical therapy in high risk febrile neutropenic patients in solid organ malignancies. |
| Databáze: | OpenAIRE |
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