Association between antifungal prophylaxis and rate of documented bacteremia in febrile neutropenic cancer patients

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
C ViscoliInternational Antimicrobial Therapy Cooperative Group of the European Organization for Research and Treatment of Cancer

Abstract

Published data have suggested a correlation between antifungal prophylaxis and bacteremia in febrile neutropenia. This correlation was investigated among 3002 febrile neutropenic patients enrolled in 4 trials during 1986-1994. Globally, 1322 patients (44%) did not receive antifungal prophylaxis; 835 (28%) received poorly absorbable antifungal agents and 845 (28%) received absorbable antifungal agents. The rates of bacteremia for these groups were 20%, 26%, and 27%, respectively (P=.0001). In a multivariate model without including antifungal prophylaxis, factors associated with bacteremia were: age, duration of hospitalization, duration of neutropenia before enrollment, underlying disease, presence of an intravenous catheter, shock, antibacterial prophylaxis, temperature, and granulocyte count at onset of fever. When antifungal prophylaxis was included, the adjustment quality of the model improved slightly (P=.05), with an odds ratio of 1.19 (95% confidence interval [CI], 0.92-1.55) for patients receiving nonabsorbable and 1.42 (95% CI, 1.07-1.88) for those who were receiving absorbable antifungal agents. Antifungal prophylaxis with absorbable agents might have an impact on the rate of documented bacteremia in febrile neutropeni...Continue Reading

References

Dec 31, 1987·The New England Journal of Medicine·UNKNOWN EORTC International Antimicrobial Therapy Cooperative GroupS H Zinner
Jan 1, 1994·European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)·C ViscoliJ Klastersky

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Citations

Jan 13, 2011·European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology·Y-K ChenH-F Tien
Nov 22, 2007·Wiener medizinische Wochenschrift·Philipp StaberPeter Neumeister
Nov 5, 2002·Critical Reviews in Oncology/hematology·C S M Oude NijhuisEveline S J M de Bont
Jul 24, 2008·Bone Marrow Transplantation·E CastagnolaC Viscoli
Sep 12, 1998·British Journal of Haematology·C Viscoli, E Castagnola
Apr 26, 2002·British Journal of Haematology·Nicole M A BlijlevensBen E de Pauw
May 8, 2001·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·R P WenzelM B Edmond
Dec 12, 2001·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Claudio ViscoliUNKNOWN International Antimicrobial Therapy Cooperative Group of the European Organization for Research and Treatment of Cancer
Jan 11, 2003·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Catherine CordonnierUNKNOWN Club de Réflexion sur les Infections en Onco-Hématologie
Jan 19, 2005·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Murat AkovaUNKNOWN International Antimicrobial Therapy Group of the European Organization for Research and Treatment of Cancer
Mar 16, 2005·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Kent A Sepkowitz
Jan 30, 2004·Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases·E CastagnolaC Viscoli
Mar 7, 2014·Stem Cells Translational Medicine·Marion E G Brunck, Lars K Nielsen
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Feb 2, 2006·The Journal of Antimicrobial Chemotherapy·C CharlierO Lortholary
Jul 20, 2002·Current Opinion in Infectious Diseases·Claudio Viscoli, Elio Castagnola

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