title: Discontinuation of empirical antibiotic therapy in neutropenic acute myeloid leukaemia patients with fever of unknown origin: is it ethical?
abstract: Based on recommendations of the ECIL-4, we prospectively evaluated discontinuation of empirical antibiotic therapy in high-risk neutropenic acute myeloid leukaemia patients with fever of unknown origin. Seven patients (median neutropenia duration 30 days) were included. Four of them remained afebrile but quickly recovered from neutropenia. The other three had rapid recurrent fever. Two of these three patients had bacteraemia with susceptible strains and one of them was transferred to the ICU for septic shock. Median duration of sparing of antibiotics for the seven patients was 3 days (2-4). Because of these limited results the study was stopped.
authors: Service d'Hématologie, Gustave Roussy Cancer Campus Grand Paris, Villejuif, France.
authors: J-B
authors: JB
authors: Micol
authors: C
authors: C
authors: Chahine
authors: P-L
authors: PL
authors: Woerther
authors: D
authors: D
authors: Ghez
authors: F
authors: F
authors: Netzer
authors: C
authors: C
authors: Dufour
authors: M
authors: M
authors: Merad
authors: F
authors: F
authors: Blot
authors: E
authors: E
authors: Chachaty
authors: S
authors: S
authors: de Botton
authors: B
authors: B
authors: Gachot
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D005260:Female; D005335:Fever of Unknown Origin / Q000188:drug therapy*; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000150:complications*; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000150:complications*; D016896:Treatment Outcome; D028761:Withholding Treatment / Q000941:ethics*
chemical_list: D000900:Anti-Bacterial Agents
keywords: Acute myeloid leukaemia; antibiotic discontinuation; bacterial resistance; fever of unknown origin; neutropenia