Evaluation of a Carbapenem-Saving Strategy Using Empirical Combination Regimen of Piperacillin-Tazobactam and Amikacin in Hemato-Oncology Patients.
- Author:
Jae Hoon KO
1
;
Si Ho KIM
;
Cheol In KANG
;
Sun Young CHO
;
Nam Yong LEE
;
Doo Ryeon CHUNG
;
Kyong Ran PECK
;
Jae Hoon SONG
Author Information
- Publication Type:Brief Communication
- Keywords: Carbapenem-Saving; Piperacillin-Tazobactam; Amikacin; Gram-Negative Bacilli; Resistance
- MeSH: Amikacin*; Febrile Neutropenia; Humans; Mortality
- From:Journal of Korean Medical Science 2019;34(2):e17-
- CountryRepublic of Korea
- Language:English
- 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.
