A European Organization for Research and Treatment of Cancer-International Antimicrobial Therapy Group Study of secondary infections in febrile, neutropenic patients with cancer

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Serval ID
serval:BIB_922723DB4E7A
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
A European Organization for Research and Treatment of Cancer-International Antimicrobial Therapy Group Study of secondary infections in febrile, neutropenic patients with cancer
Journal
Clinical Infectious Diseases
Author(s)
Akova  M., Paesmans  M., Calandra  T., Viscoli  C.
ISSN
1537-6591 (Electronic)
Publication state
Published
Issued date
01/2005
Volume
40
Number
2
Pages
239-45
Notes
Journal Article
Research Support, Non-U.S. Gov't --- Old month value: Jan 15
Abstract
BACKGROUND: Neutropenic patients with cancer may develop several episodes of fever and infection during chemotherapy-induced myeloaplasia. METHODS: To identify risk factors for secondary infectious episodes among patients who responded to initial antibiotic therapy, we retrospectively analyzed 2 consecutive, prospective, randomized clinical trials performed by the International Antimicrobial Therapy Group of the European Organization for Research and Treatment of Cancer during 1991-1994. RESULTS: Of 1720 patients with their first episode of febrile neutropenia, 836 responded to the initial antibiotic regimen and were therefore suitable for our analysis. A secondary infection was observed in 129 (15%) of 836 patients that occurred at a median of 10 days (range, 1-28 days) after the onset of the primary febrile episode. Factors at both baseline and day 4 were analyzed. Age of >16 years (odds ratio [OR], 3.46; P<.001), acute leukemia in first induction (OR, 3.17; P<.001), presence of intravenous line (OR, 1.88; P=.04), severe neutropenia (defined as an absolute granulocyte count of <100 cells/mm(3)) on day 4 (OR, 2.72; P<.001), and type of documentation of the primary episode (i.e., microbiologically documented cause or unexplained fever; OR, 2.56; P=.001) were found to be risk factors for secondary infection. The risk of death was higher among patients who developed a secondary infectious episode than among those who did not (5.4% vs. 1.4%; P<.01). CONCLUSIONS: The clinical parameters described above may help to identify neutropenic patients at risk of developing secondary infection.
Keywords
Adolescent Anti-Bacterial Agents/therapeutic use Bacterial Infections/drug therapy/*etiology/mortality Europe Female Fever/*complications Humans Male Mycoses/drug therapy/*etiology/mortality Neoplasms/*complications Neutropenia/*complications Odds Ratio Randomized Controlled Trials Retrospective Studies Risk Factors
Pubmed
Web of science
Open Access
Yes
Create date
25/01/2008 14:28
Last modification date
25/09/2019 7:10
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