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Lakshmaiah KC, Malabagi AS, Govindbabu, et al. Febrile Neutropenia in Hematological Malignancies: Clinical and Microbiological Profile and Outcome in High Risk Patients. J Lab Physicians. 2015;7(2):116-20doi: 10.4103/0974-2727.163126.
Lakshmaiah, K. C., Malabagi, A. S., Govindbabu, Shetty, R., Sinha, M., & Jayashree, R. S. (2015). Febrile Neutropenia in Hematological Malignancies: Clinical and Microbiological Profile and Outcome in High Risk Patients. Journal of laboratory physicians, 7(2), 116-20. https://doi.org/10.4103/0974-2727.163126
Lakshmaiah, Kuntegowdanahalli C, et al. "Febrile Neutropenia in Hematological Malignancies: Clinical and Microbiological Profile and Outcome in High Risk Patients." Journal of laboratory physicians vol. 7,2 (2015): 116-20. doi: https://doi.org/10.4103/0974-2727.163126
Lakshmaiah KC, Malabagi AS, Govindbabu, Shetty R, Sinha M, Jayashree RS. Febrile Neutropenia in Hematological Malignancies: Clinical and Microbiological Profile and Outcome in High Risk Patients. J Lab Physicians. 2015 Jul-Dec;7(2):116-20. doi: 10.4103/0974-2727.163126. PMID: 26417163; PMCID: PMC4559624.
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J Lab Physicians. 2015 Jul-Dec;7(2):116-20. doi: 10.4103/0974-2727.163126.

Febrile Neutropenia in Hematological Malignancies: Clinical and Microbiological Profile and Outcome in High Risk Patients.

Journal of laboratory physicians

Kuntegowdanahalli C Lakshmaiah, Abhayakumar S Malabagi, Govindbabu, Rachan Shetty, Mahua Sinha, Rudrapatna S Jayashree

Affiliations

  1. Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India.
  2. Department of Microbiology, Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India.

PMID: 26417163 PMCID: PMC4559624 DOI: 10.4103/0974-2727.163126

Abstract

BACKGROUND AND OBJECTIVES: Febrile neutropenia (FN) is considered a medical emergency. Patients with hematological malignancies (HM) commonly experience FN. Broad spectrum antibiotics have to be started empirically to prevent complications. This study depicts the clinical profile, microbiological profile, antibiotic sensitivity pattern, and outcome in high risk HM.

MATERIALS AND METHODS: In this prospective study, 72 patients with hematologic malignancies, diagnosed and treated for 108 high risk febrile neutropenic episodes from August 2011 to January 2013 at a Regional Cancer Center, in South India were analyzed. Cefoperazone-sulbactum was used as a first-line empiric antibiotic.

RESULTS: Majority of the patients with FN episodes had acute myeloid leukemia. Overall culture positivity was 29.62%. The most common organisms isolated were Gram-negative bacilli (63.64%), with Escherichia coli being the most frequent pathogen. All Gram-negative organisms were sensitive to imipenem, whereas sensitivity pattern to other antibiotics were as follows: 85.71%, 78.26%, 69.52%, 63.64%, 41.66% and 47.05% for pipercillin-tazoactum, meropenem, cefoperazone-sulbactum, amikacin, ceftazidime, ciprofloxacin respectively. Overall mortality was 13.5%. Most of the patients responded to empiric antibiotic cefoperazone-sulbactum.

CONCLUSIONS: In the hematologic malignancies particularly in acute leukemia, there is high risk of developing FN. Empiric therapy with cefoperazone-sulbactum as a first line leads to satisfactory outcome in high risk FN and therapy should be tailored to the most appropriate antibiotics according to the bacterial culture results.

Keywords: Antibiotics; Gram-negative organism; febrile neutropenia; hematological malignancies; treatment

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