Tigecycline as salvage treatment of febrile neutropenia in patients with haematological malignancies—a retrospective single-centre analysis of 200 cases
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Medientyp:
E-Artikel
Titel:
Tigecycline as salvage treatment of febrile neutropenia in patients with haematological malignancies—a retrospective single-centre analysis of 200 cases
Erschienen:
Springer Science and Business Media LLC, 2023
Erschienen in:
Annals of Hematology, 102 (2023) 9, Seite 2607-2616
Sprache:
Englisch
DOI:
10.1007/s00277-023-05222-5
ISSN:
0939-5555;
1432-0584
Entstehung:
Anmerkungen:
Beschreibung:
AbstractTigecycline has been used to treat patients with febrile neutropenia (FN). This study aims to analyse the effectiveness of tigecycline as salvage treatment of FN. Patients records from 09/2004 to 04/2019 were reviewed. Cases were eligible if fever persisted/recurred (p/r-FN) after 3 days of second-line treatment with a carbapenem, and were divided into three groups: switch to tigecycline (TGC group), switch to other antibiotics (OAB group), and no switch (W&W group). The primary endpoint was response rate (defervescence for ≥ 7 days or at least until discharge); the key secondary endpoint was 30-day mortality rate. Two hundred cases from 176 patients (median 59 years; 53.5% men) treated were included, mostly acute myeloid leukaemias (61.0%). 45.5% of cases were in the TGC group (in combination with an anti-pseudomonal antibiotic, mostly ceftazidime [95.6%]); 35.5% were in the OAB and 19.0% in the W&W group. There was no significant difference in response rates (TGC, 73.6%; OAB, 62.0%; W&W, 78.9%; p = 0.12) or 30-day mortality rates (TGC, 7.7%; OAB, 7.0%; W&W, 5.3%; p = 0.94). Tigecycline plus an anti-pseudomonal antibiotic does not improve response or 30-day mortality rate compared to other antibiotics in patients with p/r-FN. Also, in some cases, no switch in antibiotics may be necessary at all.