Artículo
Effect of Combination Antibiotic Empirical Therapy on Mortality in Neutropenic Cancer Patients with Pseudomonas aeruginosa Pneumonia
Autor/es | Albasanz-Puig, Adaia
Durà-Miralles, Xavier Laporte-Amargós, Júlia Mussetti, Alberto Ruiz-Camps, Isabel Puerta-Alcalde, Pedro Retamar Gentil, Pilar Gudiol, Carlota |
Departamento | Universidad de Sevilla. Departamento de Medicina |
Fecha de publicación | 2022 |
Fecha de depósito | 2022-11-04 |
Publicado en |
|
Resumen | 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 ... 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 blood stream infection (BSI) (2006–2018). The effect of appropriate empirical combination therapy, appropri ate 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 empiri cal 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. |
Agencias financiadoras | Instituto de Salud Carlos III Ministerio de Economia, Industria y Competitividad (MINECO). España |
Cita | Albasanz-Puig, A., Durà-Miralles, X., Laporte-Amargós, J., Mussetti, A., Ruiz-Camps, I., Puerta-Alcalde, P.,...,Gudiol, C. (2022). Effect of Combination Antibiotic Empirical Therapy on Mortality in Neutropenic Cancer Patients with Pseudomonas aeruginosa Pneumonia. Microorganisms, 10 (4), 733. https://doi.org/10.3390/microorganisms10040733. |
Ficheros | Tamaño | Formato | Ver | Descripción |
---|---|---|---|---|
Effect of Combination.pdf | 1.033Mb | [PDF] | Ver/ | |