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Albasanz-Puig, Adaia; Durà-Miralles, Xavier; Laporte-Amargós, Júlia; Mussetti, Alberto; Ruiz-Camps, Isabel; Puerta-Alcalde, Pedro; Abdala, Edson; Oltolini, Chiara; Akova, Murat; Montejo, José Miguel; Mikulska, Malgorzata; Martín-Dávila, Pilar; Herrera, Fabián; Gasch, Oriol; Drgona, Lubos; Morales, Hugo Manuel Paz; Brunel, Anne-Sophie; García, Estefanía; Isler, Burcu; Kern, Winfried V.; Retamar-Gentil, Pilar; Aguado, José María; Montero, Milagros; Kanj, Souha S.; [...]

Effect of Combination Antibiotic Empirical Therapy on Mortality in Neutropenic Cancer Patients with Pseudomonas aeruginosa Pneumonia

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  • Media type: E-Article
  • Title: Effect of Combination Antibiotic Empirical Therapy on Mortality in Neutropenic Cancer Patients with Pseudomonas aeruginosa Pneumonia
  • Contributor: Albasanz-Puig, Adaia; Durà-Miralles, Xavier; Laporte-Amargós, Júlia; Mussetti, Alberto; Ruiz-Camps, Isabel; Puerta-Alcalde, Pedro; Abdala, Edson; Oltolini, Chiara; Akova, Murat; Montejo, José Miguel; Mikulska, Malgorzata; Martín-Dávila, Pilar; Herrera, Fabián; Gasch, Oriol; Drgona, Lubos; Morales, Hugo Manuel Paz; Brunel, Anne-Sophie; García, Estefanía; Isler, Burcu; Kern, Winfried V.; Retamar-Gentil, Pilar; Aguado, José María; Montero, Milagros; Kanj, Souha S.; [...]
  • Published: MDPI AG, 2022
  • Published in: Microorganisms, 10 (2022) 4, Seite 733
  • Language: English
  • DOI: 10.3390/microorganisms10040733
  • ISSN: 2076-2607
  • Origination:
  • Footnote:
  • Description: 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.
  • Access State: Open Access