%0 Journal Article
%A Albasanz Puig, Adaia
%A Durà Miralles, Xavier
%A Laporte Amargós, Júlia
%A Mussetti, Alberto
%A Ruiz Camps, Isabel
%A Puerta Alcalde, Pedro
%A Abdala, Edson
%A Oltolini, Chiara
%A Akova, Murat
%A Montejo, José Miguel
%A Mikulska, Malgorzata
%A Martín Dávila, Pilar
%A Herrera, Fabián
%A Gasch, Oriol
%A Drgona, Lubos
%A Morales, Hugo Manuel Paz
%A Brunel, Anne-Sophie
%A García, Estefanía
%A Isler, Burcu
%A Kern, Winfried V.
%A Retamar Gentil, Pilar
%A Aguado García, José María
%A Montero, Milagros
%A Kanj, Souha S.
%A Sipahi, Oguz R.
%A Calik, Sebnem
%A Márquez Gómez, Ignacio
%A Marin, Jorge I.
%A Gomes, Marisa Z. R.
%A Hemmati, Philipp
%A Araos, Rafael
%A Peghin, Maddalena
%A Pozo, José Luis del
%A Yáñez, Lucrecia
%A Tilley, Robert
%A Manzur, Adriana
%A Novo, Andres
%A Pallarès, Natàlia
%A Bergas, Alba
%A Carratalà, Jordi
%A Gudiol, Carlota
%T Effect of Combination Antibiotic Empirical Therapy on Mortality in Neutropenic Cancer Patients with Pseudomonas aeruginosa Pneumonia
%D 2022
%@ 2076-2607
%U https://hdl.handle.net/20.500.14352/72515
%X 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.
%~