PMID: 9570172May 7, 1998Paper

Bacteremic pneumonia in neutropenic patients with cancer: causes, empirical antibiotic therapy, and outcome

Archives of Internal Medicine
Jordi CarratalàFrancesc Gudiol

Abstract

Bacteremic pneumonia is a major cause of death among neutropenic patients with cancer. We analyzed the causes, empirical antibiotic therapy, and outcome of 40 consecutive cases of bacteremic pneumonia identified among 408 episodes of bacteremia in adult neutropenic patients with cancer, prospectively documented from 1986 to 1995. The most frequent causative organisms were Pseudomonas aeruginosa (17 cases), Streptococcus pneumoniae (12 cases), Escherichia coli (5 cases), and Streptococcus mitis (3 cases). Overall, P. aeruginosa and S. pneumoniae caused 72.5% of all episodes of bacteremic pneumonia, compared with 11.4% of bacteremic episodes from other sources (P< .001). Thirty patients received ceftazidime and 10 patients received imipenem as the beta-lactam component of the initial empirical treatment. All strains of P. aeruginosa were susceptible to both agents. Forty-seven percent of streptococcal strains were penicillin resistant and showed a decreased susceptibility to ceftazidime (minimum inhibitory concentration ranged from 1 to 64 microg/mL). Five patients (12.5%) were considered to have received inappropriate empirical antibiotic therapy. Attributable mortality in patients with bacteremic pneumonia was higher than in pa...Continue Reading

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Related Concepts

Fortum
Cephalosporanic Acids
Malignant Neoplasms
Neutropenia
Thienamycins
Imipenem, Anhydrous
Bacteremia
Pneumonia, Bacterial

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