Advertisement

Empirical polymyxin B therapy in febrile neutropenic patients with hematological diseases: A prospective, multicenter, observational clinical study

Published:January 23, 2023DOI:https://doi.org/10.1016/j.jinf.2023.01.026
      We have read with great interest a study of Prof. Zhang regarding acute toxicity of intravenous polymyxin B: A safety and pharmacokinetic study in healthy Chinese subjects.
      • Liu X.
      • Chen Y.
      • Yang H.
      • Li J.
      • Yu J.
      • Yu Z.
      • et al.
      Acute toxicity is a dose-limiting factor for intravenous polymyxin B: A safety and pharmacokinetic study in healthy Chinese subjects.
      In recent decades, infections caused by multiple drug-resistant (MDR)-Gram-negative bacteria (GNB) have become a major public health threat worldwide and a challenge to current antibiotic therapy.
      • Jasovský D.
      • Littmann J.
      • Zorzet A.
      • Cars O.
      Antimicrobial resistance—a threat to the world's sustainable development.
      MDR-GNB are associated with high mortality, and effective empirical therapy is vital for patient survival.
      • Kollef K.E.
      • Schramm G.E.
      • Wills A.R.
      • Reichley R.M.
      • Micek S.T.
      • Kollef MH.
      Predictors of 30-day mortality and hospital costs in patients with ventilator-associated pneumonia attributed to potentially antibioticresistant gram-negative bacteria.
      ,
      • Tumbarello M.
      • De Pascale G.
      • Trecarichi E.M.
      • Spanu T.
      • Antonicelli F.
      • Maviglia R.
      • et al.
      Clinical outcomes of Pseudomonas aeruginosa pneumonia in intensive care unit patients.
      Patients with hematological diseases are at greater risk for MDR-GNB infection because of myelosuppression, chemotherapy-induced gastrointestinal mucositis, extended hospitalization, and regular exposure to broad-spectrum antibiotic therapy.
      • Satlin M.J.
      • Jenkins S.G.
      • Walsh TJ.
      The global challenge of carbapenem-resistant Enterobacteriaceae in transplant recipients and patients with hematologic malignancies.
      ,
      • Misch E.A.
      • Andes DR.
      Bacterial infections in the stem cell transplant recipient and hematologic malignancy patient.
      Colonization has also been identified as a risk factor for infection.
      • Dickstein Y.
      • Edelman R.
      • Dror T.
      • Hussein K.
      • Bar-Lavie Y.
      • Paul M.
      Carbapenem-resistant enterobacteriaceae colonization and infection in critically ill patients: a retrospective matched cohort comparison with non-carriers.
      .

      Keywords

      Abbreviations:

      MRD (Multiple drug-resistant), GNB (Gram-negative bacteria), CRO (Carbapenem-resistant organism), P. aeruginosa (Pseudomonas aeruginosa), K. pneumoniae (Klebsiella pneumoniae), S. maltophilia (Stenotrophomonas maltophilia), A. baumannii (Acinetobacter baumannii), E. coli (Escherichia coli)
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of Infection
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Liu X.
        • Chen Y.
        • Yang H.
        • Li J.
        • Yu J.
        • Yu Z.
        • et al.
        Acute toxicity is a dose-limiting factor for intravenous polymyxin B: A safety and pharmacokinetic study in healthy Chinese subjects.
        J Infect. 2021; 82: 207-215
        • Jasovský D.
        • Littmann J.
        • Zorzet A.
        • Cars O.
        Antimicrobial resistance—a threat to the world's sustainable development.
        Upsala J Med Sci. 2016; 121: 159-164
        • Kollef K.E.
        • Schramm G.E.
        • Wills A.R.
        • Reichley R.M.
        • Micek S.T.
        • Kollef MH.
        Predictors of 30-day mortality and hospital costs in patients with ventilator-associated pneumonia attributed to potentially antibioticresistant gram-negative bacteria.
        Chest. 2008; 134: 281-287
        • Tumbarello M.
        • De Pascale G.
        • Trecarichi E.M.
        • Spanu T.
        • Antonicelli F.
        • Maviglia R.
        • et al.
        Clinical outcomes of Pseudomonas aeruginosa pneumonia in intensive care unit patients.
        Intensiv Care Med. 2013; 39: 682-692
        • Satlin M.J.
        • Jenkins S.G.
        • Walsh TJ.
        The global challenge of carbapenem-resistant Enterobacteriaceae in transplant recipients and patients with hematologic malignancies.
        Clin Infect Dis. 2014; 58: 1274-1283
        • Misch E.A.
        • Andes DR.
        Bacterial infections in the stem cell transplant recipient and hematologic malignancy patient.
        Infect Dis Clin N Am. 2019; 33: 399
        • Dickstein Y.
        • Edelman R.
        • Dror T.
        • Hussein K.
        • Bar-Lavie Y.
        • Paul M.
        Carbapenem-resistant enterobacteriaceae colonization and infection in critically ill patients: a retrospective matched cohort comparison with non-carriers.
        J Hosp Infect. 2016; 94: 54-59
        • Kalil A.C.
        • Metersky M.L.
        • Klompas M.
        • Muscedere J.
        • Sweeney D.A.
        • Palmer L.B.
        • et al.
        Management of adults with hospital-acquired and ventilator-associated pneumonia: 2016 clinical practice guidelines by the infectious diseases society of America and the American thoracic society.
        Clin Infect Dis. 2016; 63: e61-111
        • Torres A.
        • Niederman M.S.
        • Chastre J.
        • Ewig S.
        • Fernandez-Vandellos P.
        • Hanberger H.
        • et al.
        International ERS/ESICM/ESCMID/ALAT guidelines for the management of hospital-acquired pneumonia and ventilator-associated pneumonia: guidelines for the management of hospital-acquired pneumonia (HAP)/ventilator-associated pneumonia (VAP) of the european respiratory society (ERS), european society of intensive care medicine (ESICM), european society of clinical microbiology and infectious diseases (ESCMID) and asociación latinoamericana del Tórax (ALAT).
        Eur Respir J. 2017; 501700582
        • Cisneros J.M.
        • Rosso-Fernández C.M.
        • Roca-Oporto C.
        • De Pascale G.
        • Jiménez-Jorge S.
        • Fernández-Hinojosa E.
        • et al.
        Colistin versus meropenem in the empirical treatment of ventilator-associated pneumonia (Magic Bullet study): an investigator-driven, open-label, randomized, noninferiority controlled trial.
        Crit Care. 2019; 23: 383