Effect of Combination Antibiotic Empirical Therapy on Mortality in Neutropenic Cancer Patients with Pseudomonas aeruginosa Pneumonia

Autor: Albasanz-Puig, Adaia, Durà-Miralles, Xavier, Laporte-Amargós, Júlia, Mussetti, Alberto, Ruiz-Camps, Isabel, Puerta-Alcalde, Pedro, Abdala, Edson, Oltolini, Chiara, Akova, Murat, Montejo, José Miguel, Mikulska, Malgorzata, Martín-Dávila, Pilar, Herrera, Fabián, Gasch, Oriol, Drgona, Lubos, Morales, Hugo Manuel Paz, Brunel, Anne-Sophie, García, Estefanía, Isler, Burcu, Kern, Winfried V, Retamar-Gentil, Pilar, Aguado, José María, Montero, Milagros, Kanj, Souha S, Sipahi, Oguz R, Calik, Sebnem, Márquez-Gómez, Ignacio, Marin, Jorge I, Gomes, Marisa Z R, Hemmati, Philipp, Araos, Rafael, Peghin, Maddalena, Del Pozo, José Luis, Yáñez, Lucrecia, Tilley, Robert, Manzur, Adriana, Novo, Andres, Pallarès, Natàlia, Bergas, Alba, Carratalà, Jordi, Gudiol, Carlota, On Behalf Of The Ironic Study Group
Přispěvatelé: Instituto de Salud Carlos III, Ministerio de Economía y Competitividad (España), Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (España), European Society of Clinical Microbiology and Infectious Diseases, Generalitat de Catalunya
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Microorganisms; Volume 10; Issue 4; Pages: 733
Dipòsit Digital de la UB
Universidad de Barcelona
E-Prints Complutense. Archivo Institucional de la UCM
Universitad de Lleida
ISSN: 2076-2607
DOI: 10.3390/microorganisms10040733
Popis: To assess the effect of combination antibiotic empirical therapy on 30-day case-fatality rate in neutropenic cancer patients with Pseudomonas aeruginosa (PA) bacteremic pneumonia. This was a multinational, retrospective cohort study of neutropenic onco-hematological patients with PA bloodstream infection (BSI) (2006-2018). The effect of appropriate empirical combination therapy, appropriate monotherapy and inappropriate empirical antibiotic therapy [IEAT] on 30-day case-fatality was assessed only in patients with PA bacteremic pneumonia. Among 1017 PA BSI episodes, pneumonia was the source of BSI in 294 (28.9%). Among those, 52 (17.7%) were caused by a multidrug-resistant (MDR) strain and 68 (23.1%) received IEAT, mainly when the infection was caused by an MDR strain [38/52 (73.1%) vs. 30/242 (12.4%); p < 0.001]. The 30-day case-fatality rate was higher in patients with PA bacteremic pneumonia than in those with PA BSI from other sources (55.1% vs. 31.4%; p < 0.001). IEAT was associated with increased 30-day case-fatality (aHR 1.44 [95%CI 1.01-2.03]; p = 0.042), whereas the use of appropriate combination empirical treatment was independently associated with improved survival (aHR 0.46 [95%CI 0.27-0.78]; p = 0.004). Appropriate empirical monotherapy was not associated with improved overall survival (aHR 1.25 [95%CI 0.76-2.05]; p = 0.39). Combination antibiotic empirical therapy should be administered promptly in febrile neutropenic patients with suspected pneumonia as the source of infection.
Instituto de Salud Carlos III, Subdireccion General de Redes y Centros de Investigacion Cooperativa, Ministerio de Economia, Industria y Competitividad, Centro de Investigacion Biomedica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain [CB21/13/00009, CB21/13/00079, CB21/13/00054, CB21/13/00086, CB21/13/00012]
This work was supported by the Instituto de Salud Carlos III, Subdireccion General de Redes y Centros de Investigacion Cooperativa, Ministerio de Economia, Industria y Competitividad, Centro de Investigacion Biomedica en Red de Enfermedades Infecciosas (CIBERINFEC) [CB21/13/00009, CB21/13/00079, CB21/13/00054, CB21/13/00086, CB21/13/00012], Madrid, Spain.
Databáze: OpenAIRE
Externí odkaz: