title: Response of first-line antibiotic therapy in patients with febrile neutropenia during treatment of hematological disorders.
abstract: Patients with hematological disorders develop febrile neutropenia (FN); most of these events remain undetermined in origin. We performed a prospective study to determine the microbiological characteristics of infections and their response to the first-line antibiotic therapy in FN. The study was conducted at National Institute of Blood Disease and Bone Marrow Transplant. Two-hundred episodes of FN were assessed for the bacterial growth, antimicrobial susceptibility pattern and response to the first-line treatment of FN. All patients were given Ceftazidime and Amikacin Bosch Pharmaceutical (Pvt. Ltd), as first-line antibiotic in FN. Out of 200 episodes we had 108 clinically and microbiologically documented infections. The isolated frequencies for gram negative and gram positive organisms were n = 52 and 49 (48 and 45 %) respectively. Among gram negative micro-organisms, Escherichia coli (E. coli) was isolated in 15 (28.8 %), Klebsiella pneumonae in 4 (7.6 %) and Pseudomonas aeruginosa in 10 (19.2 %) were in highest frequencies. Methicillin sensitive staphylococci emerged as the frequently isolated gram-positive bacteria. Eight-one episodes (45.3 %) responded to the first-line treatment and death reported in 20 cases (10 %). Our study showed almost equal trend of gram positive and gram negative bacteria isolated from patients suffering from neutropenic fever. Empirical use of Ceftazidime and Amikacin as first-line antibiotics was able to cover the infection only in 45.3 % of episodes suffering from FN.
authors.affiliation: Department of Hematology and Oncology, National Institute of Blood Disease & Bone Marrow Transplantation, ST 2/A Block 17 Gulshan-e-Iqbal, Sir Shah Suleman Road, KDA Scheme 24, Karachi, Pakistan.
authors.forename: M
authors.initials: M
authors.lastname: Taj
authors.affiliation: Department of Hematology and Oncology, National Institute of Blood Disease & Bone Marrow Transplantation, ST 2/A Block 17 Gulshan-e-Iqbal, Sir Shah Suleman Road, KDA Scheme 24, Karachi, Pakistan.
authors.forename: R N
authors.initials: RN
authors.lastname: Qureshi
authors.affiliation: Department of Hematology and Oncology, National Institute of Blood Disease & Bone Marrow Transplantation, ST 2/A Block 17 Gulshan-e-Iqbal, Sir Shah Suleman Road, KDA Scheme 24, Karachi, Pakistan.
authors.forename: T
authors.initials: T
authors.lastname: Farzana
authors.affiliation: Department of Hematology and Oncology, National Institute of Blood Disease & Bone Marrow Transplantation, ST 2/A Block 17 Gulshan-e-Iqbal, Sir Shah Suleman Road, KDA Scheme 24, Karachi, Pakistan.
authors.forename: T S
authors.initials: TS
authors.lastname: Shamsi
authors.affiliation: Department of Hematology and Oncology, National Institute of Blood Disease & Bone Marrow Transplantation, ST 2/A Block 17 Gulshan-e-Iqbal, Sir Shah Suleman Road, KDA Scheme 24, Karachi, Pakistan.
authors.forename: S S
authors.initials: SS
authors.lastname: Ahmed
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