Variation in Antibiotic Prescription in High-Risk Febrile Neutropenia in Portuguese Hospitals

被引:0
|
作者
Freitas, Marta [1 ]
Andrade, Paulo [2 ,3 ]
Pinto, Ricardo [4 ]
Trigo, Fernanda [4 ]
Azevedo, Ana [1 ,5 ,6 ]
Almeida, Francisco [1 ,2 ,6 ]
机构
[1] Univ Porto, Fac Med, Alameda Prof Hernani Monteiro, P-4200039 Porto, Portugal
[2] Unidade Local Saude Sao Joao, Ctr Epidemiol Hosp, Unidade Prevencao & Controlo Infecao & Resistencia, P-4200319 Porto, Portugal
[3] Unidade Local Saude Sao Joao, Serv Doencas Infecciosas, P-4200319 Porto, Portugal
[4] Unidade Local Saude Sao Joao, Serv Hematol Clin, P-4200319 Porto, Portugal
[5] Unidade Local Saude Sao Joao, Ctr Epidemiol Hosp, P-4200319 Porto, Portugal
[6] Univ Porto, Inst Saude Publ, Lab Invest Integrat & Translac Saude Populac ITR, EPIUnit, P-4050600 Porto, Portugal
来源
ANTIBIOTICS-BASEL | 2024年 / 13卷 / 09期
关键词
febrile neutropenia; high risk; antimicrobial stewardship; survey; guidelines; INFECTIOUS-DISEASES SOCIETY; CLINICAL-PRACTICE GUIDELINE; OUTPATIENT MANAGEMENT; FEVER; RESISTANCE; ONCOLOGY; THERAPY;
D O I
10.3390/antibiotics13090822
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
Introduction: Febrile neutropenia (FN) is a potentially severe entity, particularly in hemato-oncologic patients who have higher incidence of colonization with multidrug-resistant bacteria. Discrepancies among guidelines contribute to divergence in antimicrobial practices. Our objective was to assess the variation of practices in antimicrobial therapy in high-risk FN among Portuguese hematologists. Methods: We conducted a cross-sectional study through the implementation of an online survey, open to all clinical hematologists in the country. To characterize practice patterns regarding critical elements in FN management, three clinical vignettes were designed to describe typical situations where narrow-spectrum empiric antibiotics (vignette 1), short-course therapy (vignette 2) and de-escalation (vignette 3) could be performed. The remaining questions characterized clinical experience, department size, and differentiation and decision-making process regarding FN antibiotic therapy. Results: The survey yielded 31 responses from 11 hospitals across four regions. All respondents opted for empiric narrow-spectrum antibiotics, 22.6% opted for short-course therapy (mostly senior specialists from larger settings) and 35.5% for de-escalation (mostly young specialists). Availability of an FN protocol seemed to favor both approaches. These findings should be complemented by qualitative assessments of barriers to best practices and should support the need for interventions to improve antibiotic use in febrile neutropenia.
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页数:13
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