RT Journal Article
T1 Effect of Combination Antibiotic Empirical Therapy on Mortality in Neutropenic Cancer Patients with Pseudomonas aeruginosa Pneumonia
A1 Albasanz Puig, Adaia
A1 Durà Miralles, Xavier
A1 Laporte Amargós, Júlia
A1 Mussetti, Alberto
A1 Ruiz Camps, Isabel
A1 Puerta Alcalde, Pedro
A1 Abdala, Edson
A1 Oltolini, Chiara
A1 Akova, Murat
A1 Montejo, José Miguel
A1 Mikulska, Malgorzata
A1 Martín Dávila, Pilar
A1 Herrera, Fabián
A1 Gasch, Oriol
A1 Drgona, Lubos
A1 Morales, Hugo Manuel Paz
A1 Brunel, Anne-Sophie
A1 García, Estefanía
A1 Isler, Burcu
A1 Kern, Winfried V.
A1 Retamar Gentil, Pilar
A1 Aguado García, José María
A1 Montero, Milagros
A1 Kanj, Souha S.
A1 Sipahi, Oguz R.
A1 Calik, Sebnem
A1 Márquez Gómez, Ignacio
A1 Marin, Jorge I.
A1 Gomes, Marisa Z. R.
A1 Hemmati, Philipp
A1 Araos, Rafael
A1 Peghin, Maddalena
A1 Pozo, José Luis del
A1 Yáñez, Lucrecia
A1 Tilley, Robert
A1 Manzur, Adriana
A1 Novo, Andres
A1 Pallarès, Natàlia
A1 Bergas, Alba
A1 Carratalà, Jordi
A1 Gudiol, Carlota
AB 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.
PB MPDI
SN 2076-2607
YR 2022
FD 2022-03-29
LK https://hdl.handle.net/20.500.14352/72515
UL https://hdl.handle.net/20.500.14352/72515
LA eng
NO Instituto de Salud Carlos III (ISCIII)/ Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC)
DS Docta Complutense
RD 7 may 2024