지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 저널정보
- 한국병원약사회 병원약사회지 병원약사회지 제38권 제3호
- 발행연도
- 2021.8
- 수록면
- 319 - 330 (12page)
- DOI
- 10.32429/jkshp.2021.38.3.003
이용수
초록· 키워드
오류제보하기
Background : Broad-spectrum antibiotics including those with anti-pseudomonal activity are recommended based on regional and institutional epidemiologic antimicrobial-resistance profiles when selecting empirical antibiotics for febrile neutropenia. We have used ceftizoxime with amikacin as empirical antibiotics for patients with neutropenic fever. To prescribe the appropriate empirical antibiotics, periodic analysis of the current status of febrile neutropenia and the causative microorganisms is required. We analyzed the risk factors for infection resistance to ceftizoxime with amikacin in bacteremic febrile neutropenia among patients undergoing chemotherapy.
Methods : We retrospectively reviewed bloodstream infections in patients undergoing treatment for acute leukemia or hematopoietic stem cell transplantation from July 1, 2014, to June 30, 2019. Early treatment response was assessed 7 days after the onset of bacteremia by the negative conversion of follow-up blood cultures, improved C-reactive protein (CRP) levels, and defervescence. Multivariate logistic regression was used to evaluate the risk factors associated with antibiotic-resistant infection.
Results : A total of 190 bacteremia episodes were identified. The majority of the bacteria [142 (74.7%)] were gram-negative, and 11 (5.7%) were Pseudomonas aeruginosa. Ceftizoxime with amikacin (43.6%) and piperacillin with tobramycin (23.2%) was mainly used as the empirical antibiotics. The 30-day mortality was found to be 3.1%. Among 174 patients assessed for early treatment response, most of them (98.2%) showed favorable responses including the negative conversion of blood cultures, improved CRP levels (85.0%), and defervescence (81.6%). Multivariate logistic regression analysis showed that exposure to third-generation antibiotics, cephalosporin (p=0.012) or piperacillin/tazobactam (p=0.048) within 30 days prior to the onset of bacteremia were independent risk factors for infections resistant to treatment with ceftizoxime with amikacin.
Conclusion : When considering ceftizoxime with amikacin as the empirical antibiotics of choice, it should be noted that exposure to antibiotics such as third-generation cephalosporin or piperacillin/ tazobactam is limited to within 30 days prior to the onset of bacteremia.
목차
등록된 정보가 없습니다.
참고문헌 (22)
참고문헌 신청
Nucci M / 1997 / Risk factors and attributable mortality associated with superinfections in neutropenic patients with cancer / Clin Infect Dis 24(4):575~579
Akova M / 2005 / A European Organization for Research and Treatment of Cancer-Inter national Antimicrobial Therapy Group Study of secondary infections in febrile, neutropenic patients with cancer / Clin Infect Dis 40(2):239~245
Crawford J / 2004 / Chemotherapy-induced neutropenia : risks, consequences, and new directions for its management / Cancer 100(2):228~237
Klastersky J / 2007 / Bacteraemia in febrile neutropenic cancer patients / Int J Antimicrob Agents. 30(Suppl 1):S51~S59
Nesher L / 2014 / The current spectrum of infection in cancer patients with chemotherapy related neutropenia / Infection 42(1):5~13
Akova M / 2005 / A European Organization for Research and Treatment of Cancer-Inter national Antimicrobial Therapy Group Study of secondary infections in febrile, neutropenic patients with cancer / Clin Infect Dis 40(2):239~245
Crawford J / 2004 / Chemotherapy-induced neutropenia : risks, consequences, and new directions for its management / Cancer 100(2):228~237
Klastersky J / 2007 / Bacteraemia in febrile neutropenic cancer patients / Int J Antimicrob Agents. 30(Suppl 1):S51~S59
Nesher L / 2014 / The current spectrum of infection in cancer patients with chemotherapy related neutropenia / Infection 42(1):5~13
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