Effect of combination antibiotic empirical therapy on mortality in neutropenic cancer patients with pseudomonas aeruginosa pneumonia

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  • dc.contributor.author Albasanz-Puig, Adaia
  • dc.contributor.author Montero, Maria Milagro
  • dc.contributor.author Gudiol, Carlota
  • dc.contributor.author IRONIC study group
  • dc.date.accessioned 2022-11-24T07:23:32Z
  • dc.date.available 2022-11-24T07:23:32Z
  • dc.date.issued 2022
  • dc.description.abstract 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.
  • dc.format.mimetype application/pdf
  • dc.identifier.citation Albasanz-Puig A, Durà-Miralles X, Laporte-Amargós J, Mussetti A, Ruiz-Camps I, Puerta-Alcalde P, et al. Effect of combination antibiotic empirical therapy on mortality in neutropenic cancer patients with pseudomonas aeruginosa pneumonia. Microorganisms. 2022 Mar 29; 10(4): 733. DOI: 10.3390/microorganisms10040733
  • dc.identifier.doi http://dx.doi.org/10.3390/microorganisms10040733
  • dc.identifier.issn 2076-2607
  • dc.identifier.uri http://hdl.handle.net/10230/54994
  • dc.language.iso eng
  • dc.publisher MDPI
  • dc.rights Copyright © 2022 by Albasanz-Puig A, Durà-Miralles X, Laporte-Amargós J, Mussetti A, Ruiz-Camps I, Puerta-Alcalde P, et al. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
  • dc.rights.accessRights info:eu-repo/semantics/openAccess
  • dc.rights.uri http://creativecommons.org/licenses/by/4.0/
  • dc.subject.keyword Pseudomonas aeruginosa
  • dc.subject.keyword Bloodstream infection
  • dc.subject.keyword Neutropenia
  • dc.subject.keyword Pneumonia
  • dc.subject.keyword Septic shock
  • dc.title Effect of combination antibiotic empirical therapy on mortality in neutropenic cancer patients with pseudomonas aeruginosa pneumonia
  • dc.type info:eu-repo/semantics/article
  • dc.type.version info:eu-repo/semantics/publishedVersion

Col·leccions

Articles (Hospital del Mar Research Institute)
Articles (Departament de Medicina i Ciències de la Vida)