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short antibiotic neutropenic

Lenaïg Le Clech, Jean-Philippe Talarmin, Marie-Anne Couturier, Jean-Christophe Ianotto, Christophe Nicol, Ronan Le Calloch, Stéphanie Dos Santos, Pascal Hutin, Didier Tandé, Virginie Cogulet, Christian Berthou, Gaëlle Guillerm
INTRODUCTION: Immediate empirical antibiotic therapy is mandatory in febrile chemotherapy-induced neutropenia, but its optimal duration is unclear, especially in patients with fever of unknown origin (FUO). OBJECTIVES: The primary objective of this 20-month prospective observational study was to evaluate the feasibility and safety of short-term antibiotic treatment in afebrile or febrile patients exhibiting FUO, irrespective of their neutrophil count. The secondary objective was to describe the epidemiology of all episodes of febrile neutropenia...
February 16, 2018: Infectious Diseases
Jason D Goldman, Amelia Gallaher, Rupali Jain, Zach Stednick, Manoj Menon, Michael J Boeckh, Paul S Pottinger, Stephen M Schwartz, Corey Casper
Background: Patients with cancer are at high risk for severe sepsis and septic shock (SS/SSh), and a delay in receiving effective antibiotics is strongly associated with mortality. Delays are due to logistics of clinic flow and drug delivery. In an era of increasing antimicrobial resistance, combination therapy may be superior to monotherapy for patients with SS/SSh. Patients and Methods: At the Seattle Cancer Care Alliance, we implemented the Sepsis STAT Pack (SSP) program to simplify timely and effective provision of empiric antibiotics and other resuscitative care to outpatients with cancer with suspected SS/SSh before hospitalization...
April 2017: Journal of the National Comprehensive Cancer Network: JNCCN
Yusuke Shono, Melissa D Docampo, Jonathan U Peled, Suelen M Perobelli, Enrico Velardi, Jennifer J Tsai, Ann E Slingerland, Odette M Smith, Lauren F Young, Jyotsna Gupta, Sophia R Lieberman, Hillary V Jay, Katya F Ahr, Kori A Porosnicu Rodriguez, Ke Xu, Marco Calarfiore, Hendrik Poeck, Silvia Caballero, Sean M Devlin, Franck Rapaport, Jarrod A Dudakov, Alan M Hanash, Boglarka Gyurkocza, George F Murphy, Camilla Gomes, Chen Liu, Eli L Moss, Shannon B Falconer, Ami S Bhatt, Ying Taur, Eric G Pamer, Marcel R M van den Brink, Robert R Jenq
Intestinal bacteria may modulate the risk of infection and graft-versus-host disease (GVHD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Allo-HSCT recipients often develop neutropenic fever, which is treated with antibiotics that may target anaerobic bacteria in the gut. We retrospectively examined 857 allo-HSCT recipients and found that treatment of neutropenic fever with imipenem-cilastatin and piperacillin-tazobactam antibiotics was associated with increased GVHD-related mortality at 5 years (21...
May 18, 2016: Science Translational Medicine
Daniel Knappe, Knut Adermann, Ralf Hoffmann
Oncocins and apidaecins are short proline-rich antimicrobial peptides (PrAMPs) representing novel antibiotic drug lead compounds that kill bacteria after internalization and inhibition of intracellular targets (e.g. 70S ribosome and DnaK). Oncocin Onc72 is highly active against Gram-negative bacteria in vitro and in vivo protecting mice in systemic infection models with Escherichia coli and KPC-producing Klebsiella pneumoniae. Here we studied its efficacy in a murine thigh infection model using meropenem as antibiotic comparator that had a 44-fold higher molar in vitro activity than Onc72...
November 2015: Biopolymers
Doğukan Aktaş, Bilge Demirel, Tuğba Gürsoy, Fahri Ovalı
BACKGROUND: To investigate the efficacy and safety of recombinant human granulocyte colony-stimulating factor, recombinant human granulocyte-macrophage colony-stimulating factor (rhG-CSF) to treat sepsis in neutropenic preterm infants. METHODS: Fifty-six neutropenic preterm infants with suspected or culture-proven sepsis hospitalized in Zeynep Kamil Maternity and Children's Educational and Training Hospital, Kozyatağı/Istanbul, Turkey between January 2008 and January 2010 were enrolled...
June 2015: Pediatrics and Neonatology
Isabel Antonieta Iturrieta-González, Ana Carolina Barbosa Padovan, Fernando César Bizerra, Rosane Christine Hahn, Arnaldo Lopes Colombo
Invasive infections caused by Trichosporon spp. have increased considerably in recent years, especially in neutropenic and critically ill patients using catheters and antibiotics. The genus presents limited sensitivity to different antifungal agents, but triazoles are the first choice for treatment. Here, we investigated the biofilm production and antifungal susceptibility to triazoles and amphotericin B of 54 Trichosporon spp. isolates obtained from blood samples (19), urine (20) and superficial mycosis (15)...
2014: PloS One
Csaba Fehér, Montserrat Rovira, Alex Soriano, Jordi Esteve, José Antonio Martínez, Francesc Marco, Enric Carreras, Carmen Martínez, Francesc Fernández-Avilés, María Suárez-Lledó, Josep Mensa
OBJECTIVES: Information on the efficacy of extended meropenem administration in neutropenic patients is scarce. Our objective was to determine whether the administration of meropenem in a 4 h extended infusion (EI) leads to a better clinical outcome in patients with febrile neutropenia than the conventional short infusion (SI). METHODS: This was a retrospective observational study. The subjects were neutropenic patients who presented with fever after receiving haematopoietic stem-cell transplantation or induction chemotherapy for acute myeloid leukaemia...
September 2014: Journal of Antimicrobial Chemotherapy
Djamel Mokart, Géraldine Slehofer, Jérôme Lambert, Antoine Sannini, Laurent Chow-Chine, Jean-Paul Brun, Pierre Berger, Ségolène Duran, Marion Faucher, Jean-Louis Blache, Colombe Saillard, Norbert Vey, Marc Leone
BACKGROUND: In severe sepsis, guidelines recommend de-escalating the empirical antimicrobial treatment as soon as the microbiological results are available. We aimed to determine the rate of de-escalation of the empirical antimicrobial treatment in neutropenic patients with severe sepsis. The characteristics of antimicrobial treatment associated with de-escalation and its impact on short- and long-term survival were also determined. METHODS: In the intensive care unit (ICU) of a cancer referral center, we prospectively collected observational data related to the antimicrobial management in neutropenic patients who developed severe sepsis and were admitted to ICU for at least 48 h...
January 2014: Intensive Care Medicine
Jennifer A Pratt, Melisa K Stricherz, Priya S Verghese, Michael J Burke
Neutropenic fever is a common complication of myelosuppressive therapy in pediatric oncology patients. Piperacillin-tazobactam (PIP/TAZO) is a broad spectrum antibiotic used for empiric treatment of neutropenic fever. We describe four cases of suspected PIP/TAZO induced nephrotoxicity occurring in children with pediatric malignancies admitted to the hospital and treated for fever ± neutropenia. All patients exhibited acute renal injury shortly after PIP/TAZO administration with one of these cases having biopsy evidence of acute interstitial nephritis...
February 2014: Pediatric Blood & Cancer
Minako Mori, Tomoya Kitagawa, Yuya Sasaki, Kazuyo Yamamoto, Takashi Onaka, Akihito Yonezawa, Kazunori Imada
A 63-year-old man had been treated with intensive chemotherapy for acute myeloid leukemia. On the 49th hospital day, he had febrile neutropenia after the second course of induction chemotherapy. On the 53 rd hospital day, he presented with hemoptysis and developed acute respiratory failure requiring ventilator support within several hours. On the 54th hospital day, the patient died with hemorrhagic respiratory infection. Stenotrophomonas maltophilia was detected in bacterial cultures of his blood, bronchoalveolar lavage, and sputum...
May 2012: Kansenshōgaku Zasshi. the Journal of the Japanese Association for Infectious Diseases
Bob Phillips, Ros Wade, Marie Westwood, Richard Riley, Alex J Sutton
INTRODUCTION:   Children and young people who present with febrile neutropenia (FNP) secondary to malignancies or their treatment frequently do not undergo routine chest radiography. With shorter courses of antibiotic therapy, failure to recognise pneumonia and consequent under-treatment could produce significant problems. METHODS:   The review was conducted determine the value of the absence of clinical features of lower respiratory tract infection in excluding radiographic pneumonia at presentation of FNP using Centre for Reviews and Dissemination methods...
August 2012: Journal of Paediatrics and Child Health
Nicklas Sundell, Håkan Boström, Mats Edenholm, Jonas Abrahamsson
AIM: To describe the symptoms, clinical management and short-term outcome in a series of paediatric oncology patients with severe typhlitis following conservative treatment. METHODS: Twelve episodes of severe typhlitis in 11 children with cancer treated at the paediatric oncology ward at Queen Silvias Children's Hospital between 1995 and 2006 were analysed retrospectively. Data on symptoms, radiological findings, laboratory status and treatment as well as outcome were collected and analysed...
March 2012: Acta Paediatrica
Anne-Claire Gac, Jean-Jacques Parienti, Sylvain Chantepie, Sabine Fradin, Xavier Le Coutour, Roland Leclercq, Oumedaly Reman
Sensitive markers of infection are rare or of limited validity in neutropenic patients. Procalcitonin (PCT), a precursor protein of calcitonin, is a specific and sensitive marker of severe bacterial infections during short-term neutropenia. Because the value of PCT measurements among patients undergoing long periods of neutropenia remains uncertain and because several mechanisms, such as bacterial or fungal infections, reactions to drugs or blood products or tumor-associated events, can cause fever, we described the dynamics of PCT in 29 acute myeloid leukemia (AML) patients with 39 instances of chemotherapy-induced neutropenia...
October 2011: Leukemia Research
M van Vliet, C M J Potting, P D J Sturm, J P Donnelly, N M A Blijlevens
With fever being the most common manifestation of early sepsis, clinical practice guidelines emphasise the prompt institution of broad-spectrum antibacterial therapy at its onset. An audit was performed on the haematology ward to determine whether there was any delay in starting antibiotic treatment during neutropenia in clinical patients and to define the main reasons for this. Strategies were developed, implemented and evaluated on short- and long-term implications on the delay in the start of antibacterial therapy...
September 2011: European Journal of Cancer Care
M Mizanur Rahman, Mohiuddin Ahmed Khan
Infection in chemotherapy-induced neutropenia (neutrophils < 500/mm3) is the main cause of death during the treatment of acute leukemia. Antibiotic prophylaxis is a controversial issue to prevent or delay this infection. This study assessed the efficacy of prophylaxis with oral levofloxacin in chemotherapy-induced febrile neutropenic patients. Eighty patients of acute leukemia was randomly assigned to had levofoxacin (500 mg/daily) or placebo from the starting of chemotherapy. Out of 80 patients 53 developed neutropenia and fever...
December 2009: Bangladesh Medical Research Council Bulletin
Flavia Marturana, Nicholas E Timmins, Lars K Nielsen
BACKGROUND AIMS: Despite the availability of modern antibiotics/antimycotics and cytokine support, neutropenic infection accounts for the majority of chemotherapy-associated deaths. While transfusion support with donor neutrophils is possible, cost and complicated logistics make such an option unrealistic on a routine basis. A manufactured neutrophil product could enable routine prophylactic administration of neutrophils, preventing the onset of neutropenia and substantially reducing the risk of infection...
March 2011: Cytotherapy
Ghous Gondal, Egil Johnson, Vemund Paulsen, Banitalebi Hasan
BACKGROUND: Neutropenic enterocolitis is a life-threatening complication that usually occurs in connection with chemotherapy for acute leukemias. Our experience with diagnosis and treatment of these patients is presented. MATERIAL AND METHODS: Medical records from patients treated for neutropenic enterocolitis at Ullevaal University Hospital in the period 2000-2008 were retrospectively reviewed. RESULTS: 16 patients with median age 33 years were treated for neutropenic enterocolitis...
January 28, 2010: Tidsskrift for Den Norske Lægeforening: Tidsskrift for Praktisk Medicin, Ny Række
Michael Ellis, Roos Bernsen, Hussein Ali-Zadeh, Jörgen Kristensen, Ulla Hedström, Lazaros Poughias, Mark Bresnik, Awad Al-Essa, David A Stevens
A high intermittent dose regimen (group A: 10 mg kg(-1) on day 1, 5 mg kg(-1) on days 3 and 6) was compared with standard dosing (group B: 3 mg kg(-1) per day for 14 days) of liposomal amphotericin B (LAB) for empirical treatment of persistent febrile neutropenia. A total cumulative dose of 1275 mg (group A) and 2800 mg (group B) was administered. Infusion-related adverse drug events, mainly rigors/chills, occurred more frequently with group A (11/45, 24 % infusions) than with group B (12/201, 6 % infusions) (P=0...
November 2009: Journal of Medical Microbiology
Trijn Israëls, Marianne D van de Wetering, Peter Hesseling, Nan van Geloven, Huib N Caron, Elizabeth M Molyneux
BACKGROUND: Infection in neutropenic children is a major cause of morbidity and mortality in children treated for cancer. In developing countries, children with cancer are often malnourished at diagnosis. In Blantyre, Malawi, children with Burkitt lymphoma are treated with a local protocol with limited toxicity. The aim of this study was to evaluate the incidence and outcome of febrile neutropenia during this treatment and the association with malnutrition at diagnosis. METHODS: We documented nutritional status, febrile and/or neutropenic episodes, antibiotic therapy and short term outcome of all children with Burkitt lymphoma treated according to the local protocol and admitted from January 2007 to March 2008...
July 2009: Pediatric Blood & Cancer
Olivier Lortholary, Agnès Lefort, Michel Tod, Anne-Marie Chomat, Clémence Darras-Joly, Catherine Cordonnier
We review experimental and clinical data on the pharmacokinetics and pharmacodynamics of antibacterial drugs in febrile neutropenic hosts. Since major pharmacokinetic changes have been reported for various classes of antibiotics in these patients, we advocate the need for adequate initial dosing regimens in all cases. Monitoring drug serum concentrations is mandatory for aminoglycosides and glycopeptides, and special attention should be paid to the dosing frequency of the short half-life beta-lactams to optimise the management of febrile neutropenia, especially in patients with severe sepsis...
October 2008: Lancet Infectious Diseases
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