High-risk febrile neutropenia in Auckland 2003-2004: the influence of the microbiology laboratory on patient treatment and the use of pathogen-specific therapy

Background: International guidelines recommend routine microbiological assessment of patients with febrile neutropenia, but do not recommend a change from broad‐spectrum antibiotic therapy to pathogen‐specific therapy when a clinically relevant organism has been isolated. The aim of the study was to...

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Bibliographic Details
Published in:Internal medicine journal 2007-01, Vol.37 (1), p.26-31
Main Authors: Ritchie, S., Palmer, S., Ellis-Pegler, R.
Format: Article
Language:English
Subjects:
Anti-Bacterial Agents - administration & dosage
Anti-Bacterial Agents - classification
Anti-Bacterial Agents - therapeutic use
Bacteremia - drug therapy
Bacteremia - epidemiology
Bacteremia - microbiology
Bacteria - drug effects
Bacteria - isolation & purification
Bacterial Infections - diagnosis
Bacterial Infections - drug therapy
Bacterial Infections - epidemiology
Bacterial Infections - microbiology
Catheterization - adverse effects
Cephalosporins - administration & dosage
Cephalosporins - therapeutic use
disease management
Drug Resistance
Equipment Contamination
febrile neutropenia
Fever - etiology
Gentamicins - administration & dosage
Gentamicins - therapeutic use
Hematologic Diseases - complications
Hematologic Neoplasms - complications
hospital laboratory
Hospitals, Urban - statistics & numerical data
Humans
Laboratories, Hospital - statistics & numerical data
Medical Audit
Microbial Sensitivity Tests
Neutropenia - diagnosis
Neutropenia - drug therapy
Neutropenia - epidemiology
Neutropenia - etiology
Neutropenia - microbiology
New Zealand - epidemiology
pathogen-specific therapy
Prospective Studies
Risk Assessment
Species Specificity
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Summary:Background: International guidelines recommend routine microbiological assessment of patients with febrile neutropenia, but do not recommend a change from broad‐spectrum antibiotic therapy to pathogen‐specific therapy when a clinically relevant organism has been isolated. The aim of the study was to determine the aetiology of febrile neutropenia in adult haematology patients at Auckland City Hospital, to document the changes in treatment made following isolation of a clinically relevant organism and to assess adverse outcomes in any patient who received pathogen‐specific therapy after a positive culture result. Methods: The results of all microbiological tests together with antibiotic therapy were recorded from consecutive patients with fever and a neutrophil count
ISSN:1444-0903
1445-5994
DOI:10.1111/j.1445-5994.2006.01239.x