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Efficacy of Tigecycline as Salvage Therapy in Multidrug-Resistant Febrile Neutropenia in Patients with Acute Leukemia—A Single Center Analysis
Severe infectious complications remain the main cause of mortality in leukemia patients due to a long period of profound neutropenia. Standardized regimens for antimicrobial, antifungal, and antiviral prophylaxis and therapy in neutropenic patients have improved infection-associated mortality. Never...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8868403/ https://www.ncbi.nlm.nih.gov/pubmed/35203731 http://dx.doi.org/10.3390/antibiotics11020128 |
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author | Modemann, Franziska Härterich, Steffen Schulze zur Wiesch, Julian Rohde, Holger Lindeman, Nick Benjamin Bokemeyer, Carsten Fiedler, Walter Ghandili, Susanne |
author_facet | Modemann, Franziska Härterich, Steffen Schulze zur Wiesch, Julian Rohde, Holger Lindeman, Nick Benjamin Bokemeyer, Carsten Fiedler, Walter Ghandili, Susanne |
author_sort | Modemann, Franziska |
collection | PubMed |
description | Severe infectious complications remain the main cause of mortality in leukemia patients due to a long period of profound neutropenia. Standardized regimens for antimicrobial, antifungal, and antiviral prophylaxis and therapy in neutropenic patients have improved infection-associated mortality. Nevertheless, many patients are refractory to these multidrug approaches. Tigecycline is a last-resort antibiotic with a broad-spectrum activity; unfortunately, clinical experience in multidrug-resistant febrile neutropenia is limited. The aim was to evaluate the efficacy of tigecycline treatment in comparison to standard treatment in this patient cohort. In this single center analysis, we analyzed the clinical courses of 73 patients with acute leukemia and diagnosis of febrile neutropenia resistant to hospital-based multidrug escalation levels who continued on a standard approach without antibiotics as the last resort (n = 30) or were switched to tigecycline in addition to carbapenem treatment (n = 43). We observed comparable overall response rates (decrease in C-reactive protein or resolution of fever) in both patient cohorts. Switching the antibiotic approach to tigecycline showed lower absolute sepsis (33% vs. 47%, p = 0.235) and infection-associated mortality rates (5% vs. 13%, p = 0.221). Prospective larger randomized studies are necessary to underline these results and to be able to generate reliable statistics. |
format | Online Article Text |
id | pubmed-8868403 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-88684032022-02-25 Efficacy of Tigecycline as Salvage Therapy in Multidrug-Resistant Febrile Neutropenia in Patients with Acute Leukemia—A Single Center Analysis Modemann, Franziska Härterich, Steffen Schulze zur Wiesch, Julian Rohde, Holger Lindeman, Nick Benjamin Bokemeyer, Carsten Fiedler, Walter Ghandili, Susanne Antibiotics (Basel) Article Severe infectious complications remain the main cause of mortality in leukemia patients due to a long period of profound neutropenia. Standardized regimens for antimicrobial, antifungal, and antiviral prophylaxis and therapy in neutropenic patients have improved infection-associated mortality. Nevertheless, many patients are refractory to these multidrug approaches. Tigecycline is a last-resort antibiotic with a broad-spectrum activity; unfortunately, clinical experience in multidrug-resistant febrile neutropenia is limited. The aim was to evaluate the efficacy of tigecycline treatment in comparison to standard treatment in this patient cohort. In this single center analysis, we analyzed the clinical courses of 73 patients with acute leukemia and diagnosis of febrile neutropenia resistant to hospital-based multidrug escalation levels who continued on a standard approach without antibiotics as the last resort (n = 30) or were switched to tigecycline in addition to carbapenem treatment (n = 43). We observed comparable overall response rates (decrease in C-reactive protein or resolution of fever) in both patient cohorts. Switching the antibiotic approach to tigecycline showed lower absolute sepsis (33% vs. 47%, p = 0.235) and infection-associated mortality rates (5% vs. 13%, p = 0.221). Prospective larger randomized studies are necessary to underline these results and to be able to generate reliable statistics. MDPI 2022-01-19 /pmc/articles/PMC8868403/ /pubmed/35203731 http://dx.doi.org/10.3390/antibiotics11020128 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Modemann, Franziska Härterich, Steffen Schulze zur Wiesch, Julian Rohde, Holger Lindeman, Nick Benjamin Bokemeyer, Carsten Fiedler, Walter Ghandili, Susanne Efficacy of Tigecycline as Salvage Therapy in Multidrug-Resistant Febrile Neutropenia in Patients with Acute Leukemia—A Single Center Analysis |
title | Efficacy of Tigecycline as Salvage Therapy in Multidrug-Resistant Febrile Neutropenia in Patients with Acute Leukemia—A Single Center Analysis |
title_full | Efficacy of Tigecycline as Salvage Therapy in Multidrug-Resistant Febrile Neutropenia in Patients with Acute Leukemia—A Single Center Analysis |
title_fullStr | Efficacy of Tigecycline as Salvage Therapy in Multidrug-Resistant Febrile Neutropenia in Patients with Acute Leukemia—A Single Center Analysis |
title_full_unstemmed | Efficacy of Tigecycline as Salvage Therapy in Multidrug-Resistant Febrile Neutropenia in Patients with Acute Leukemia—A Single Center Analysis |
title_short | Efficacy of Tigecycline as Salvage Therapy in Multidrug-Resistant Febrile Neutropenia in Patients with Acute Leukemia—A Single Center Analysis |
title_sort | efficacy of tigecycline as salvage therapy in multidrug-resistant febrile neutropenia in patients with acute leukemia—a single center analysis |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8868403/ https://www.ncbi.nlm.nih.gov/pubmed/35203731 http://dx.doi.org/10.3390/antibiotics11020128 |
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