دورية أكاديمية
Low utilization of vancomycin in febrile neutropenia: real-world evidence from 4 Brazilian centers.
| العنوان: | Low utilization of vancomycin in febrile neutropenia: real-world evidence from 4 Brazilian centers. |
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| المؤلفون: | Ramos JF; Hospital Sírio-Libanês, Sao Paulo, Brazil., Pereira AD; Universidade Federal de São Paulo, Sao Paulo, Brazil.; Instituto de Cardiologia Do Distrito Federal, Brasília, Brazil., Seiwald MCN; Hospital Sírio-Libanês, Sao Paulo, Brazil., Gandolpho LS; Universidade Federal de São Paulo, Sao Paulo, Brazil.; Hospital Nove de Julho - Rede DASA, Sao Paulo, Brazil., Molla VC; Universidade Federal de São Paulo, Sao Paulo, Brazil.; Hospital Nove de Julho - Rede DASA, Sao Paulo, Brazil., Guaraná M; Universidade Federal Do Rio de Janeiro, Rio de Janeiro, Brazil., Nouér SA; Universidade Federal Do Rio de Janeiro, Rio de Janeiro, Brazil., Nucci M; Universidade Federal Do Rio de Janeiro, Rio de Janeiro, Brazil. mnucci@hucff.ufrj.br.; Grupo Oncoclínicas, Brazil. mnucci@hucff.ufrj.br., Rodrigues CA; Universidade Federal de São Paulo, Sao Paulo, Brazil.; Hospital Nove de Julho - Rede DASA, Sao Paulo, Brazil. |
| المصدر: | Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer [Support Care Cancer] 2023 Nov 10; Vol. 31 (12), pp. 687. Date of Electronic Publication: 2023 Nov 10. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Springer International Country of Publication: Germany NLM ID: 9302957 Publication Model: Electronic Cited Medium: Internet ISSN: 1433-7339 (Electronic) Linking ISSN: 09414355 NLM ISO Abbreviation: Support Care Cancer Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Berlin : Springer International, c1993- |
| مواضيع طبية MeSH: | Vancomycin*/therapeutic use , Vancomycin*/adverse effects , Febrile Neutropenia*/drug therapy , Febrile Neutropenia*/chemically induced, Humans ; Adolescent ; Young Adult ; Adult ; Middle Aged ; Aged ; Aged, 80 and over ; Anti-Bacterial Agents ; Retrospective Studies ; Brazil ; Fever/etiology ; Fever/chemically induced |
| مستخلص: | Purpose: The prompt initiation of a betalactam antibiotic in febrile neutropenic patients is considered standard of care, while the empiric use of vancomycin is recommended by guidelines in specific situations, with a low level of evidence. The objective of this study was to assess the utilization of vancomycin in the management of febrile neutropenia within four Brazilian medical centers that implemented more stringent criteria for its administration. Methods: A comprehensive retrospective analysis was performed encompassing all instances of febrile neutropenia observed during the period from 2013 to 2019. The primary focus was to identify the reasons for initiating vancomycin therapy. Results: A total of 536 consecutive episodes of febrile neutropenia were documented, involving 384 patients with a median age of 52 years (range 18-86). Chemotherapy preceded febrile neutropenia in 59.7% of cases, while 40.3% occurred after hematopoietic stem cell transplantation. The most prevalent underlying diseases were acute myeloid leukemia (26.5%) and non-Hodgkin's lymphoma (22%). According to international guidelines, vancomycin should have been initiated at the onset of fever in 145 episodes (27%); however, it was administered in only 27 cases (5.0%). Three episodes were associated with Staphylococcus aureus bacteremia, two of which were methicillin resistant. The 15-day and 30-day mortality rates were 5.0% and 9.9%, respectively. Conclusions: The results of this study underscore the notably low utilization rate of vancomycin in cases of febrile neutropenia, despite clear indications outlined in established guidelines. These findings emphasize the importance of carefully implementing guideline recommendations, considering local epidemiological factors, especially when the strength of recommendation is weak. (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.) |
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| فهرسة مساهمة: | Keywords: Antibiotic; Antimicrobial stewardship; Empiric therapy; Febrile neutropenia; Neutropenia; Vancomycin |
| المشرفين على المادة: | 6Q205EH1VU (Vancomycin) 0 (Anti-Bacterial Agents) |
| تواريخ الأحداث: | Date Created: 20231110 Date Completed: 20231113 Latest Revision: 20231221 |
| رمز التحديث: | 20231221 |
| DOI: | 10.1007/s00520-023-08152-0 |
| PMID: | 37947888 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1433-7339 |
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| DOI: | 10.1007/s00520-023-08152-0 |