Practicing Antimicrobial Stewardship: De-Escalating Antibiotics in Patients With Acute Myeloid Leukemia and Neutropenic Fever

Risa Fuller; Erin Moshier; Samantha E Jacobs; Douglas Tremblay; Guido Lancman; Alexander Coltoff; Jessica Caro; John Mascarenhas; Meenakshi Rana

doi:10.1093/ofid/ofaa138

Practicing Antimicrobial Stewardship: De-Escalating Antibiotics in Patients With Acute Myeloid Leukemia and Neutropenic Fever

Open Forum Infect Dis. 2020 Apr 21;7(5):ofaa138. doi: 10.1093/ofid/ofaa138. eCollection 2020 May.

Authors

Risa Fuller¹, Erin Moshier², Samantha E Jacobs¹, Douglas Tremblay³, Guido Lancman³, Alexander Coltoff³, Jessica Caro³, John Mascarenhas³, Meenakshi Rana¹

Affiliations

¹ Division of Infectious Disease, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
² TCI Biostatistics Shared Resource Facility, Institute for Healthcare Delivery Science, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
³ Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.

Abstract

We compared risk of recurrent fever in patients with acute myeloid leukemia undergoing induction chemotherapy with febrile neutropenia without an infectious source in which antibacterials were de-escalated before neutrophil recovery versus continued. There was less recurrent fever when antibacterials were de-escalated early with no increased adverse events.

Keywords: acute myeloid leukemia; antimicrobial stewardship; neutropenic fever.