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Cefpodoxime for antimicrobial prophylaxis in neutropenia: a retrospective case series.

Abstract：

BACKGROUND:Antimicrobial prophylaxis in select neutropenic patients has reduced fever, infection rates, hospital length of stay, and hospitalization rates. Guidelines from the Infectious Diseases Society of America recommend the consideration of prophylaxis with a fluoroquinolone in patients at high risk for infection after chemotherapy. The use of fluoroquinolones has been associated with many adverse events, and there is limited evidence on alternative antimicrobial prophylaxis in patients intolerant of fluoroquinolones. OBJECTIVES:Our study describes a single-center experience of cefpodoxime as an alternative to fluoroquinolones for antibacterial prophylaxis during neutropenia after chemotherapy and represents a retrospective evaluation of an oral cephalosporin in adult patients for this purpose. METHODS:This retrospective case series analyzed data from the electronic medical records of 41 patients having hematologic malignancies and given cefpodoxime for neutropenic prophylaxis. RESULTS:The rate of febrile neutropenia was 85%, with 60% culture-positive infections. Gram-positive organisms were identified in 52% of positive cultures, and gram-negative organisms represented 40% of positive cultures. Antimicrobial resistance to guideline-recommended empiric treatment regimens was not seen in breakthrough infections. CONCLUSIONS:Cefpodoxime can be utilized for prophylaxis, without adversely affecting resistance to broad-spectrum agents, and maintains a high level of appropriateness of guideline-recommended empiric regimens. This study of cefpodoxime prophylaxis in adult patients intolerant to fluoroquinolones adds to the literature of potential alternative agents for prophylaxis in neutropenic patients.

journal_name

Clin Ther

journal_title

Clinical therapeutics

authors

Wojenski DJ,Barreto JN,Wolf RC,Tosh PK

doi

10.1016/j.clinthera.2014.04.013

subject

Has Abstract

pub_date

2014-06-01 00:00:00

pages

976-81

issue

6

eissn

0149-2918

issn

1879-114X

pii

S0149-2918(14)00211-2

journal_volume

36

pub_type

杂志文章

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