%0 Journal Article
%A Albasanz-Puig, Adaia
%A Dura-Miralles, Xavier
%A Laporte-Amargos, Julia
%A Mussetti, Alberto
%A Ruiz-Camps, Isabel
%A Puerta-Alcalde, Pedro
%A Abdala, Edson
%A Oltolini, Chiara
%A Akova, Murat
%A Montejo, Jose Miguel
%A Mikulska, Malgorzata
%A Martin-Davila, Pilar
%A Herrera, Fabian
%A Gasch, Oriol
%A Drgona, Lubos
%A Paz-Morales, Hugo Manuel 
%A Brunel, Anne-Sophie
%A Garcia, Estefanía
%A Isler, Burcu
%A Kern, Winfried V
%A Retamar-Gentil, Pilar
%A Aguado, Jose Maria
%A Montero, Milagros
%A Kanj, Souha S
%A Sipahi, Oguz R
%A Calik, Sebnem
%A Marquez-Gomez, Ignacio
%A Marin, Jorge I
%A Gomes, Marisa Z R
%A Hemmati, Philipp
%A Araos, Rafael
%A Peghin, Maddalena
%A Del-Pozo, Jose Luis
%A Yañez, Lucrecia
%A Tilley, Robert
%A Manzur, Adriana
%A Novo, Andres
%A Pallares, Natalia
%A Bergas, Alba
%A Carratala, Jordi
%A Gudiol, Carlota
%T Effect of Combination Antibiotic Empirical Therapy on Mortality in Neutropenic Cancer Patients with Pseudomonas aeruginosa Pneumonia.
%D 2022
%@ 2076-2607
%U http://hdl.handle.net/10668/21434
%X To assess the effect of combination antibiotic empirical therapy on 30-day case-fatality rate in neutropenic cancer patients with Pseudomonas aeruginosa (PA) bacteremic pneumonia. This was a multinational, retrospective cohort study of neutropenic onco-hematological patients with PA bloodstream infection (BSI) (2006−2018). The effect of appropriate empirical combination therapy, appropriate monotherapy and inappropriate empirical antibiotic therapy [IEAT] on 30-day case-fatality was assessed only in patients with PA bacteremic pneumonia. Among 1017 PA BSI episodes, pneumonia was the source of BSI in 294 (28.9%). Among those, 52 (17.7%) were caused by a multidrug-resistant (MDR) strain and 68 (23.1%) received IEAT, mainly when the infection was caused by an MDR strain [38/52 (73.1%) vs. 30/242 (12.4%); p< 0.001]. The 30-day case-fatality rate was higher in patients with PA bacteremic pneumonia than in those with PA BSI from other sources (55.1% vs. 31.4%; p < 0.001). IEAT was associated with increased 30-day case-fatality (aHR 1.44 [95%CI 1.01–2.03]; p = 0.042), whereas the use of appropriate combination empirical treatment was independentlyassociated with improved survival (aHR 0.46 [95%CI 0.27–0.78]; p = 0.004). Appropriate empirical monotherapy was not associated with improved overall survival (aHR 1.25 [95%CI 0.76–2.05]; p = 0.39). Combination antibiotic empirical therapy should be administered promptly in febrile neutropenic patients with suspected pneumonia as the source of infection
%K Pseudomonas aeruginosa
%K Bloodstream infection
%K Neutropenia
%K Pneumonia
%K Septic shock
%~