A Prospective Observational Study of Antibiotic Therapy in Febrile Neutropenia Patients with Hematological Malignances from Multiple centers in Northeast China.
OBJECTIVE
Febrile neutropenia (FN) is a common but lethal complication of chemotherapy in hematological malignance. The aim of this study was to identify the prognostic risk factors for antibiotic treatment outcome in PN patients, and provide the optimal choice for the initial empirical antibiotic treatment.


METHODS
227 consecutive FN hematologic malignancies from four hospitals in Northeast China were enrolled. The outcome of antibiotic therapy was investigated until 14 days after the onset of FN. The factors affecting antibiotic therapy outcome were evaluated using Univariate analysis and Multivariate logistic regression analysis.


RESULTS
Among all patients, 27 patients did not achieve favorable outcome either clinically or bacteriologically. It was shown that the risk factors for poor FN therapy outcome were associated with prolonged duration of neutropenia over 9 days during FN (P=0.019), slow neutrophil recovery (P=0.039), respiratory infection (P=0.005), and that initial monotherapy with drugs recommended by the guidelines indicated better outcome (P=0.009). Additionally, patients with multi-bacterial infection, as well as further ANC decrease after fever, had a poor prognosis.


CONCLUSIONS
Our results indicate that early application of antibiotics and prevention of respiratory infection as well as good clinical care are able to improve clinical outcomes from empirical antibiotic treatment in FN patients with hematological malignances.
Institute of Hematology and Blood Diseases Hospital, CAMS and PUMC, Tianjin, China. Electronic address: zhaiweihua@eyou.com.
Weihua
W
Zhai
Institute of Hematology and Blood Diseases Hospital, CAMS and PUMC, Tianjin, China. Electronic address: lovingyvonne@163.com.
Xiaoyu
X
Zhang
Institute of Hematology and Blood Diseases Hospital, CAMS and PUMC, Tianjin, China. Electronic address: katewjl@medmail.com.cn.
Jialin
J
Wei
Department of hematology, the first center hospital of Tianjin. Electronic address: kachydeng@hotmail.com.
Qi
Q
Deng
Department of hematology, affiliated Qilu hospital of Shandong medical school. Electronic address: sdsgr@sina.com.
Xiaoyuan
X
Dong
Department of hematology, the second affiliated hospital of Hebei medical school. Electronic address: xiaoleixueye@126.com.
Xiaolei
X
Zhang
Institute of Hematology and Blood Diseases Hospital, CAMS and PUMC, Tianjin, China. Electronic address: zoexin@126.com.
Guixin
G
Zhang
Institute of Hematology and Blood Diseases Hospital, CAMS and PUMC, Tianjin, China. Electronic address: maqiaoling88@126.com.
Qiaoling
Q
Ma
Institute of Hematology and Blood Diseases Hospital, CAMS and PUMC, Tianjin, China. Electronic address: zhangeongli333@sina.com.
Rongli
R
Zhang
Institute of Hematology and Blood Diseases Hospital, CAMS and PUMC, Tianjin, China. Electronic address: sudong1026@126.com.
Dong
D
Su
Institute of Hematology and Blood Diseases Hospital, CAMS and PUMC, Tianjin, China. Electronic address: sizhoufeng@medmail.com.cn.
Sizhou
S
Feng
Institute of Hematology and Blood Diseases Hospital, CAMS and PUMC, Tianjin, China. Electronic address: mzhan@medmail.com.cn.
Mingzhe
M
Han
D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D064146:Chemotherapy-Induced Febrile Neutropenia / Q000188:drug therapy* / Q000382:microbiology; D002681:China; D005260:Female; D019337:Hematologic Neoplasms / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D055815:Young Adult
D000900:Anti-Bacterial Agents
Febrile neutropenia; antibiotics therapy; hematology malignance