Clinical efficacy of cycling empirical antibiotic therapy for febrile neutropenia in pediatric cancer patients

Hideto Teranishi, Yuhki Koga, Hisanori Nishio, Wakako Kato, Hiroaki Ono, Shunsuke Kanno, Kentaro Nakashima, Hidetoshi Takada

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background Febrile neutropenia (FN) is the main treatment-related cause of mortality among children with cancer, as the prolonged use of broad-spectrum antibiotics can lead to antibiotic resistance in these patients. Antibiotic cycling has been reported to limit the emergence of antibiotic-resistant bacteria among adult patients. However, no studies have evaluated pediatric patients with FN. Methods Between September 2011 and February 2014, 126 pediatric cancer patients were admitted to our center for chemotherapy and/or hematopoietic stem cell transplantation and were included in this study. Retrospective and prospective data collection were performed before and after antibiotic cycling, respectively. Between September 2011 and November 2012 (before antibiotic cycling was implemented), intravenous cefpirome was used as the empirical therapy for FN. Between December 2012 and February 2014 (after antibiotic cycling was implemented), the monthly antibiotic cycling involved intravenous piperacillin-tazobactam (PIPC/TAZ), intravenous meropenem or ciprofloxacin (CPFX), and intravenous cefepime in that order. For children aged ≥13 years, the monthly cycling involved intravenous PIPC/TAZ, and CPFX was administered. Results The detection rates for extended-spectrum β-lactamase producers in blood and stool culture samples decreased significantly after the implementation of antibiotic cycling (0.33/1000 patient-days vs 0/1000 patient-days, p = 0.03; 1.00/1000 patient-days vs 0/1000 patient-days, p < 0.01; respectively). Conclusion Antibiotic cycling was associated with a decreased emergence of multidrug-resistant microbes.

Original languageEnglish
Pages (from-to)463-467
Number of pages5
JournalJournal of Infection and Chemotherapy
Volume23
Issue number7
DOIs
Publication statusPublished - Jul 2017

Fingerprint

Febrile Neutropenia
Pediatrics
Anti-Bacterial Agents
Neoplasms
Therapeutics
cefpirome
meropenem
Ciprofloxacin
Child Mortality
Hematopoietic Stem Cell Transplantation
Microbial Drug Resistance
Bacteria
Drug Therapy

All Science Journal Classification (ASJC) codes

  • Microbiology (medical)
  • Pharmacology (medical)
  • Infectious Diseases

Cite this

Clinical efficacy of cycling empirical antibiotic therapy for febrile neutropenia in pediatric cancer patients. / Teranishi, Hideto; Koga, Yuhki; Nishio, Hisanori; Kato, Wakako; Ono, Hiroaki; Kanno, Shunsuke; Nakashima, Kentaro; Takada, Hidetoshi.

In: Journal of Infection and Chemotherapy, Vol. 23, No. 7, 07.2017, p. 463-467.

Research output: Contribution to journalArticle

Teranishi, Hideto ; Koga, Yuhki ; Nishio, Hisanori ; Kato, Wakako ; Ono, Hiroaki ; Kanno, Shunsuke ; Nakashima, Kentaro ; Takada, Hidetoshi. / Clinical efficacy of cycling empirical antibiotic therapy for febrile neutropenia in pediatric cancer patients. In: Journal of Infection and Chemotherapy. 2017 ; Vol. 23, No. 7. pp. 463-467.
@article{38ed8a4122f04b4cad332383c834da25,
title = "Clinical efficacy of cycling empirical antibiotic therapy for febrile neutropenia in pediatric cancer patients",
abstract = "Background Febrile neutropenia (FN) is the main treatment-related cause of mortality among children with cancer, as the prolonged use of broad-spectrum antibiotics can lead to antibiotic resistance in these patients. Antibiotic cycling has been reported to limit the emergence of antibiotic-resistant bacteria among adult patients. However, no studies have evaluated pediatric patients with FN. Methods Between September 2011 and February 2014, 126 pediatric cancer patients were admitted to our center for chemotherapy and/or hematopoietic stem cell transplantation and were included in this study. Retrospective and prospective data collection were performed before and after antibiotic cycling, respectively. Between September 2011 and November 2012 (before antibiotic cycling was implemented), intravenous cefpirome was used as the empirical therapy for FN. Between December 2012 and February 2014 (after antibiotic cycling was implemented), the monthly antibiotic cycling involved intravenous piperacillin-tazobactam (PIPC/TAZ), intravenous meropenem or ciprofloxacin (CPFX), and intravenous cefepime in that order. For children aged ≥13 years, the monthly cycling involved intravenous PIPC/TAZ, and CPFX was administered. Results The detection rates for extended-spectrum β-lactamase producers in blood and stool culture samples decreased significantly after the implementation of antibiotic cycling (0.33/1000 patient-days vs 0/1000 patient-days, p = 0.03; 1.00/1000 patient-days vs 0/1000 patient-days, p < 0.01; respectively). Conclusion Antibiotic cycling was associated with a decreased emergence of multidrug-resistant microbes.",
author = "Hideto Teranishi and Yuhki Koga and Hisanori Nishio and Wakako Kato and Hiroaki Ono and Shunsuke Kanno and Kentaro Nakashima and Hidetoshi Takada",
year = "2017",
month = "7",
doi = "10.1016/j.jiac.2017.03.020",
language = "English",
volume = "23",
pages = "463--467",
journal = "Journal of Infection and Chemotherapy",
issn = "1341-321X",
publisher = "Elsevier BV",
number = "7",

}

TY - JOUR

T1 - Clinical efficacy of cycling empirical antibiotic therapy for febrile neutropenia in pediatric cancer patients

AU - Teranishi, Hideto

AU - Koga, Yuhki

AU - Nishio, Hisanori

AU - Kato, Wakako

AU - Ono, Hiroaki

AU - Kanno, Shunsuke

AU - Nakashima, Kentaro

AU - Takada, Hidetoshi

PY - 2017/7

Y1 - 2017/7

N2 - Background Febrile neutropenia (FN) is the main treatment-related cause of mortality among children with cancer, as the prolonged use of broad-spectrum antibiotics can lead to antibiotic resistance in these patients. Antibiotic cycling has been reported to limit the emergence of antibiotic-resistant bacteria among adult patients. However, no studies have evaluated pediatric patients with FN. Methods Between September 2011 and February 2014, 126 pediatric cancer patients were admitted to our center for chemotherapy and/or hematopoietic stem cell transplantation and were included in this study. Retrospective and prospective data collection were performed before and after antibiotic cycling, respectively. Between September 2011 and November 2012 (before antibiotic cycling was implemented), intravenous cefpirome was used as the empirical therapy for FN. Between December 2012 and February 2014 (after antibiotic cycling was implemented), the monthly antibiotic cycling involved intravenous piperacillin-tazobactam (PIPC/TAZ), intravenous meropenem or ciprofloxacin (CPFX), and intravenous cefepime in that order. For children aged ≥13 years, the monthly cycling involved intravenous PIPC/TAZ, and CPFX was administered. Results The detection rates for extended-spectrum β-lactamase producers in blood and stool culture samples decreased significantly after the implementation of antibiotic cycling (0.33/1000 patient-days vs 0/1000 patient-days, p = 0.03; 1.00/1000 patient-days vs 0/1000 patient-days, p < 0.01; respectively). Conclusion Antibiotic cycling was associated with a decreased emergence of multidrug-resistant microbes.

AB - Background Febrile neutropenia (FN) is the main treatment-related cause of mortality among children with cancer, as the prolonged use of broad-spectrum antibiotics can lead to antibiotic resistance in these patients. Antibiotic cycling has been reported to limit the emergence of antibiotic-resistant bacteria among adult patients. However, no studies have evaluated pediatric patients with FN. Methods Between September 2011 and February 2014, 126 pediatric cancer patients were admitted to our center for chemotherapy and/or hematopoietic stem cell transplantation and were included in this study. Retrospective and prospective data collection were performed before and after antibiotic cycling, respectively. Between September 2011 and November 2012 (before antibiotic cycling was implemented), intravenous cefpirome was used as the empirical therapy for FN. Between December 2012 and February 2014 (after antibiotic cycling was implemented), the monthly antibiotic cycling involved intravenous piperacillin-tazobactam (PIPC/TAZ), intravenous meropenem or ciprofloxacin (CPFX), and intravenous cefepime in that order. For children aged ≥13 years, the monthly cycling involved intravenous PIPC/TAZ, and CPFX was administered. Results The detection rates for extended-spectrum β-lactamase producers in blood and stool culture samples decreased significantly after the implementation of antibiotic cycling (0.33/1000 patient-days vs 0/1000 patient-days, p = 0.03; 1.00/1000 patient-days vs 0/1000 patient-days, p < 0.01; respectively). Conclusion Antibiotic cycling was associated with a decreased emergence of multidrug-resistant microbes.

UR - http://www.scopus.com/inward/record.url?scp=85019350399&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85019350399&partnerID=8YFLogxK

U2 - 10.1016/j.jiac.2017.03.020

DO - 10.1016/j.jiac.2017.03.020

M3 - Article

C2 - 28527651

AN - SCOPUS:85019350399

VL - 23

SP - 463

EP - 467

JO - Journal of Infection and Chemotherapy

JF - Journal of Infection and Chemotherapy

SN - 1341-321X

IS - 7

ER -