Febrile neutropenic patients with solid neoplasms have few P. aeruginosa infections and higher antibacterial doses showed no benefit over lower doses

Abstract

Background: Many febrile neutropenic patients (FNP) with solid tumors receive high dose antibacterial therapy adequate forP. aeruginosa infections. This study was designed to determine the frequency of P. aeruginosa infections in FNP with solidneoplasms and detect any differences in duration of fever, length of stay (LOS) and deaths of patients receiving low (LD) vs. highdose (HD) antibacterial therapy.

Methods: Electronic medical record databases were searched to identify patients with drug-induced neutropenia and fever. Theresulting data was searched manually for patients with solid neoplasms and these charts were selected consecutively for manualreview for additional inclusion criteria, comparison characteristics, such as type of neoplasm, comorbidities, potential risk factorssuch as duration of neutropenia, documented infections, and outcomes: duration of temperature to < 37.5℃ and < 38℃ , lengthof stay (LOS), and cause of death. Components of the Multinational Association for Supportive Care of Cancer risk index(MASCCRI) were extracted and the index was calculated for each episode.

Results: The respective outcomes of LD vs. HD were: mean duration of temperature to < 38℃, 3 vs. 3 days, and to < 37.5℃, 4vs. 4 days, mean LOS 6.3 vs. 6.6 days (p = .56, TT; but p < .01, WRST), and LOS 10 days , 90% vs. 89%, Zero vs. 2 developedP. aeruginosa infections.

Conclusions: LD antibacterials for FNP with solid neoplasms did not prolong the time to afebrile or the LOS, and only 2 P.aeruginosa infections occurred. High dose antibacterial therapy may not be necessary for FNP with solid neoplasms.