Clinical efficacy of cycling empirical antibiotic therapy for febrile neutropenia in pediatric cancer patients

Journal of Infection and Chemotherapy : Official Journal of the Japan Society of Chemotherapy
Hideto TeranishiHidetoshi Takada

Abstract

Febrile neutropenia (FN) is the main treatment-related cause of mortality among children with cancer, as the prolonged use of broad-spectrum antibiotics can lead to antibiotic resistance in these patients. Antibiotic cycling has been reported to limit the emergence of antibiotic-resistant bacteria among adult patients. However, no studies have evaluated pediatric patients with FN. Between September 2011 and February 2014, 126 pediatric cancer patients were admitted to our center for chemotherapy and/or hematopoietic stem cell transplantation and were included in this study. Retrospective and prospective data collection were performed before and after antibiotic cycling, respectively. Between September 2011 and November 2012 (before antibiotic cycling was implemented), intravenous cefpirome was used as the empirical therapy for FN. Between December 2012 and February 2014 (after antibiotic cycling was implemented), the monthly antibiotic cycling involved intravenous piperacillin-tazobactam (PIPC/TAZ), intravenous meropenem or ciprofloxacin (CPFX), and intravenous cefepime in that order. For children aged ≥13 years, the monthly cycling involved intravenous PIPC/TAZ, and CPFX was administered. The detection rates for extended-spect...Continue Reading

Citations

Oct 22, 2019·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Joshua Wolf, Elisa Margolis
Nov 22, 2019·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Brandon J WebbDaanish Hoda
Aug 20, 2021·British Journal of Clinical Pharmacology·Marianneta Chatzopoulou, Lucy Reynolds

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