title: Management of infection in patients with acute leukemia during chemotherapy in Japan: questionnaire analysis by the Japan Adult Leukemia Study Group.
abstract: Guidelines for the management of febrile neutropenia (FN), deep fungal infection or use of granulocyte colony-stimulating factor (G-CSF) published in the US and Europe cannot be directly applied in other countries. In this study, we undertook a questionnaire survey of member institutions of the Japan Adult Leukemia Study Group to investigate the status of, and problems with, the management of infectious complications in patients with acute leukemia. The questionnaire consisted of 52 multiple-choice questions covering therapeutic environment, antibacterial, and antifungal prophylaxis, empirical therapy (ET) for FN, and use of G-CSF. The results were compared to a previous survey performed in 2001. Usable responses were received from 134 of 184 (71.7%) institutions. With regard to antibacterial prophylaxis, fluoroquinolones and sulfamethoxazole-trimethoprim were most commonly used. Regarding antifungal prophylaxis, the most frequently used agent was fluconazole, followed by itraconazole. In ET for FN, monotherapy with cephems or carbapenems accounted for almost all of the responses. Most respondents indicated that they used micafungin (MCFG) in ET. Prophylactic use of G-CSF during remission induction therapy in acute myeloid leukemia was reported by only 4% of respondents. Strategies for antibacterial and antifungal prophylaxis or treatment of FN should be reviewed and updated as needed.
authors: Department of Rheumatology/Hematology/Infectious Disease, Yokohama City University Hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan. hfujita@yokohama-cu.ac.jp.|Japan Adult Leukemia Study Group, Hamamatsu, Japan. hfujita@yokohama-cu.ac.jp.
authors: Hiroyuki
authors: H
authors: Fujita
authors: Japan Adult Leukemia Study Group, Hamamatsu, Japan.
authors: Minoru
authors: M
authors: Yoshida
authors: Japan Adult Leukemia Study Group, Hamamatsu, Japan.
authors: Katsuhiro
authors: K
authors: Miura
authors: Japan Adult Leukemia Study Group, Hamamatsu, Japan.
authors: Tetsuaki
authors: T
authors: Sano
authors: Japan Adult Leukemia Study Group, Hamamatsu, Japan.
authors: Katsuyuki
authors: K
authors: Kito
authors: Japan Adult Leukemia Study Group, Hamamatsu, Japan.
authors: Masatomo
authors: M
authors: Takahashi
authors: Japan Adult Leukemia Study Group, Hamamatsu, Japan.
authors: Kazuyuki
authors: K
authors: Shigeno
authors: Japan Adult Leukemia Study Group, Hamamatsu, Japan.
authors: Yoshinobu
authors: Y
authors: Kanda
authors: Japan Adult Leukemia Study Group, Hamamatsu, Japan.
authors: Nobu
authors: N
authors: Akiyama
authors: Japan Adult Leukemia Study Group, Hamamatsu, Japan.
authors: Naoko
authors: N
authors: Hatsumi
authors: Japan Adult Leukemia Study Group, Hamamatsu, Japan.
authors: Kazunori
authors: K
authors: Ohnishi
authors: Japan Adult Leukemia Study Group, Hamamatsu, Japan.
authors: Shuichi
authors: S
authors: Miyawaki
authors: Japan Adult Leukemia Study Group, Hamamatsu, Japan.
authors: Tomoki
authors: T
authors: Naoe
mesh_terms: D000208:Acute Disease; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000935:Antifungal Agents / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000150:complications / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D005334:Fever / Q000150:complications; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use*; D019538:Health Care Surveys; D006801:Humans; D007564:Japan; D007938:Leukemia / Q000150:complications*; D009181:Mycoses / Q000150:complications / Q000188:drug therapy*; D009503:Neutropenia / Q000150:complications; D011795:Surveys and Questionnaires
chemical_list: D000900:Anti-Bacterial Agents; D000935:Antifungal Agents; D016179:Granulocyte Colony-Stimulating Factor