title: Results of high-risk neutropenia therapy of hematology-oncology patients in a university hospital in Uruguay.
abstract: BACKGROUND
  Febrile neutropenia is an important cause of mortality and morbidity in hematology-oncology patients undergoing chemotherapy. The management of febrile neutropenia is typically algorithm-driven. The aim of this study was to assess the results of a standardized protocol for the treatment of febrile neutropenia.
  
  
  METHODS
  A retrospective cohort study (2011-2012) was conducted of patients with high-risk neutropenia in a hematology-oncology service.
  
  
  RESULTS
  Forty-four episodes of 17 patients with a median age of 48 years (range: 18-78 years) were included. The incidence of febrile neutropenia was 61.4%. The presence of febrile neutropenia was associated with both the duration and severity of neutropenia. Microbiological agents were isolated from different sources in 59.3% of the episodes with bacteremia isolated from blood being the most prevalent (81.3%). Multiple drug-resistant gram-negative bacilli were isolated in 62.5% of all microbiologically documented infections. Treatment of 63% of the episodes in which the initial treatment was piperacillin/tazobactam needed to be escalated to meropenem. The mortality rate due to febrile neutropenia episodes was 18.5%.
  
  
  CONCLUSIONS
  The high rate of gram-negative bacilli resistant to piperacillin/tazobactam (front-line antibiotics in our protocol) and the early need to escalate to carbapenems raises the question as to whether it is necessary to change the current protocol.
authors: Universidad de la República, Montevideo, Uruguay. Electronic address: matilde_boada@hotmail.com.
authors: Matilde
authors: M
authors: Boada Burutaran
authors: Universidad de la República, Montevideo, Uruguay.
authors: Regina
authors: R
authors: Guadagna
authors: Universidad de la República, Montevideo, Uruguay.
authors: Sofia
authors: S
authors: Grille
authors: Universidad de la República, Montevideo, Uruguay.
authors: Mariana
authors: M
authors: Stevenazzi
authors: Universidad de la República, Montevideo, Uruguay.
authors: Cecilia
authors: C
authors: Guillermo
authors: Universidad de la República, Montevideo, Uruguay.
authors: Lilian
authors: L
authors: Diaz
keywords: Clinical protocols; Drug resistance, bacterial; Gram-negative bacterial infections; Hematologic diseases; Neutropenia
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