title: Evaluation of febrile neutropenia in patients undergoing hematopoietic stem cell transplantation.
abstract: The aim of this study was to determine the incidence and causes of fever as a major problem contributing to transplantation related mortality among patients undergoing hematopoietic stem cell transplantation (HSCT) and evaluation of antibiotic use, according to reliable guidelines.We retrospectively reviewed hospital records of 195 adult patients who underwent HSCT between 2009-2011 at hematology-oncology and bone marrow transplantation research center. Baseline information and also data related to fever and neutropenia, patient's outcomes, duration of hospitalization and antibiotic use pattern were documented.A total of 195 patients were analyzed and a total of 268 febrile episodes in 180 patients were recorded (mean 1.5 episodes per patient). About 222 episodes (82%) were associated with neutropenia which one-fourth of them were without any documented infection sources. Microbiologic documents showed that the relative frequencies of gram positive and gram negative bacteria were 62.5% and 37.5%, respectively. The hospital stay duration was directly related to the numbers of fever episodes (P<0.0001).The rate of febrile episodes in autologous stem cell transplantation was significantly higher compared to allogeneic type (P<0.05).It is necessary to determine not only the local profile of microbiologic pattern, but also antibiotic sensitivities in febrile neutropenic patients following hematopoietic stem cell transplantation, and reassess response to antibiotic treatment to establish any necessity for modifications to treatment guidelines in order to prevent any fatal complications from infection.
authors.affiliation: Department of Clinical Pharmacy, Faculty of Pharmacy,Tehran University of Medical Sciences, Tehran, Iran.. zjahangard@razi.tums.ac.ir.
authors.forename: Shahideh
authors.initials: S
authors.lastname: Amini
authors.affiliation: Research Center for Rational Use of Drug and Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.. zjahangard@razi.tums.ac.ir.
authors.forename: Molouk
authors.initials: M
authors.lastname: Hadjibabaie
authors.affiliation: Department of Clinical Pharmacy, Faculty of Pharmacy,Tehran University of Medical Sciences, Tehran, Iran.. zjahangard@razi.tums.ac.ir.
authors.forename: Zahra
authors.initials: Z
authors.lastname: Jahangard-Rafsanjani
authors.affiliation: Department of Hematology Oncology, Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran.. zjahangard@razi.tums.ac.ir.
authors.forename: Asieh
authors.initials: A
authors.lastname: Ashuri
authors.affiliation: Department of Pharmaceutical Care, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.. zjahangard@razi.tums.ac.ir.
authors.forename: Hassan
authors.initials: H
authors.lastname: Torkamandi
authors.affiliation: Department of Hematology Oncology, Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran.. zjahangard@razi.tums.ac.ir.
authors.forename: Ardeshir
authors.initials: A
authors.lastname: Ghavamzadeh
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D064147:Febrile Neutropenia / Q000503:physiopathology*; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D055815:Young Adult