Antimicrobial Regimens Prescribed by Canadian Physicians for Chemotherapy-Induced Febrile Neutropenic Episodes
Loading...
Date
1999-1-1
Authors
Laverdière, Michel
Bow, Eric J
Rotstein, Coleman
Ioannou, Stratis
Carr, Danielle
Moghaddam, Narguess
the Canadian Fluconazole Study Group,
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
OBJECTIVE: To study the antimicrobial management of cancer patients with chemotherapy-induced neutropenia by Canadian physicians.SETTING: A cohort of 274 cancer patients with severe neutropenia (ie, less than 0.5×109 neutrophils/L) who participated in a prospective double-blind, placebo controlled study on antifungal prophylaxis conducted in 14 Canadian university-affiliated centres. Antifungal prophylaxis (oral fluconazole 400 mg daily) was administered to 153 of 274 (56%) patients.RESULTS: Antibacterial prophylaxis with a quinolone was given to 87 patients (32%) at the onset of chemotherapy whereas trimethoprim/sulphamethoxazole was given to 56 (20%) patients. Fever (ie, 38°C or over) occurred in 216 (79%) patients after a median duration of neutropenia of four days (range one to 31 days). Empirical antibacterial antibiotics were administered in 214 febrile patients. In 164 (77%) patients antibiotics were started during the first 24 h of fever. Monotherapy with a third generation cephalosporin and duotherapy with a antipseudomonal beta-lactam and an aminoglycoside were prescribed in 69 (32%) and 61 (28%) of the febrile patients, respectively. Inclusion of vancomycin in the initial empirical regimen was noted in 32 (15%) patients. Modifications of the initial regimen occurred in 187 (87%) patients after a median of five days (range one to 28 days). Empirical systemic amphotericin B was added after a median duration of nine days (range one to 34 days) of the empirical antibacterial regimen.CONCLUSIONS: Overall, the antimicrobial management of cancer patients with chemotherapy-induced neutropenia by Canadian physicians follows the current guidelines promulgated by the Infectious Diseases Society of America.
Description
Keywords
Citation
Michel Laverdière, Eric J Bow, Coleman Rotstein, et al., “Antimicrobial Regimens Prescribed by Canadian Physicians for Chemotherapy-Induced Febrile Neutropenic Episodes,” Canadian Journal of Infectious Diseases, vol. 10, no. 5, pp. 353-357, 1999. doi:10.1155/1999/721790