Prediction of gram-negative bacteremia in patients with cancer and febrile neutropenia by means of interleukin-8 levels in serum: targeting empirical monotherapy versus combination therapy.
In a prospective observational study of 133 neutropenic episodes, interleukin (IL)-8 serum levels > 2000 pg/mL at the onset of fever had a sensitivity of 53% and a specificity of 97% as a predictor of gram-negative bacteremia (GNB; positive predictive value, 73%; negative predictive value, 94%). The rates of early death differed significantly between patients with high and those with low IL-8 levels (3/11 vs. 1/122; P< .01). Serum IL-8 levels at the onset of fever define a low-risk subgroup of patients who can safely be treated with monotherapy.
Department of Medicine, Section of Infectious Diseases and Clinical Immunology, University Hospital and Medical Center, D-89070 Ulm, Germany. winfried.kern@medizin.uni-ulm.de
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D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D000077723:Cefepime; D002511:Cephalosporins / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005334:Fever / Q000209:etiology; D005839:Gentamicins / Q000627:therapeutic use; D016905:Gram-Negative Bacterial Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D006801:Humans; D016209:Interleukin-8 / Q000097:blood*; D007938:Leukemia / Q000150:complications*; D008223:Lymphoma / Q000150:complications*; D008297:Male; D008875:Middle Aged; D009428:Netilmicin / Q000627:therapeutic use; D009503:Neutropenia / Q000150:complications*; D011237:Predictive Value of Tests; D011446:Prospective Studies
D002511:Cephalosporins; D005839:Gentamicins; D016209:Interleukin-8; D009428:Netilmicin; D000077723:Cefepime