Evaluation of a Carbapenem-Saving Strategy Using Empirical Combination Regimen of Piperacillin-Tazobactam and Amikacin in Hemato-Oncology Patients.

Abstract

We implemented a carbapenem-saving strategy in hemato-oncology patients from 2013, using an empirical combination of piperacillin-tazobactam and amikacin for high-risk hemato-oncology patients with febrile neutropenia, who remain hemodynamically unstable > 72 hours despite initial cefepime treatment. All-cause mortality was not different between the two periods (6.54 and 6.57 deaths per 1,000 person-day, P = 0.926). Group 2 carbapenem use significantly decreased after strategy implementation (78.43 vs. 67.43 monthly days of therapy, P = 0.018), while carbapenem-resistant gram-negative bacilli did not show meaningful changes during the study period. Our carbapenem-saving strategy could effectively suppress carbapenem use without an increase of overall mortality.

• Authors: Jae-Hoon Ko, Si-Ho Kim, Cheol-In Kang, Sun Young Cho, Nam Yong Lee, Doo Ryeon Chung, Kyong Ran Peck, Jae-Hoon Song
• Journal: Journal of Korean medical science (J Korean Med Sci) Vol. 34 Issue 2 Pg. e17 (Jan 14 2019) ISSN: 1598-6357 [Electronic] Korea (South)
• PMID: 30636947 (Publication Type: Journal Article)

Chemical References

• Anti-Bacterial Agents
• Carbapenems
• Piperacillin, Tazobactam Drug Combination
• Amikacin

Topics

• Amikacin (pharmacology, therapeutic use)
• Anti-Bacterial Agents (therapeutic use)
• Carbapenems (pharmacology, therapeutic use)
• Drug Resistance, Bacterial
• Enterobacteriaceae (drug effects)
• Febrile Neutropenia (drug therapy, microbiology, pathology)
• Humans
• Piperacillin, Tazobactam Drug Combination (pharmacology, therapeutic use)