Efficacy of Antibiotic Short Course for Bloodstream Infections in Acute Myeloid Leukemia Patients With Febrile Neutropenia

Efficacy of Antibiotic Short Course for Bloodstream Infections in Acute Myeloid Leukemia Patients With Febrile Neutropenia: a Retrospective Comparative Study

There is no specific recommendation about antimicrobial treatment length for documented infections in chemotherapy induced febrile neutropenia. The aim of this study was to compare long versus short antibiotic course for bloodstream infection treatment in acute myeloid leukemia patients during febrile neutropenia. This monocentric retrospective comparative study included all consecutive bloodstream infection episodes among acute myeloid leukemia patients with febrile neutropenia for 3 years (2017-2019). Episodes were classified regarding the length of antibiotic treatment, considered as short course if the treatment lasted ≤7 days, except for nonfermenting bacteria and Staphylococcus aureus or lugdunensis for which the threshold was ≤10 days and ≤14 days, respectively. The primary outcome was the number of bloodstream infection relapses in both groups within 30 days of antibiotic discontinuation.

Study Overview

• Status: Completed
• Conditions: Acute Myeloid Leukemia; Febrile Neutropenia; Bloodstream Infection
• Intervention / Treatment: Drug: Antibiotic

• Study Type: Observational
• Enrollment (Actual): 104

Contacts and Locations

Study Locations

• France
  • Poitiers, France, 86000
    • University Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

All bloodstream infection episodes occuring in patients suffering from febrile neutropenia during acute myeloid leukemia between January 2017 and December 2019 in University Hospital of Poitiers were included.

Description

Inclusion Criteria:

• Acute myeloid leukemia
• chemo-induced febrile neutropenia
• Bloodstream infection

Exclusion Criteria:

• lack of data
• endovascular infections
• surgical treatment required
• central nervous system infections
• antibiotic treatment < 4 days
• death before the end of antibiotic treatment
• unappropriated antibiotic treatment at 48h
• relapses of bloodstream infection episodes already included
• hematopoietic stem cell transplant

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Short course treatment; Patients who received antibiotic for 7 or less days, except for nonfermenting bacteria and Staphylococcus aureus or lugdunensis for which the threshold was 10 days and 14 days, respectively.	Drug: Antibiotic; Antibiotic duration of treatment defined if the patient belonged to long course or short course group.
Long course treatment; Patients who received antibiotic for more than 7 days, except for nonfermenting bacteria and Staphylococcus aureus or lugdunensis for which the threshold was 10 days and 14 days, respectively.	Drug: Antibiotic; Antibiotic duration of treatment defined if the patient belonged to long course or short course group.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Bloodstream infection relapses	The primary outcome was to compare the number of bloodstream infection relapses in both groups within 30 days of antibiotic discontinuation.	within 30 days of antibiotic discontinuation

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Mortality	Comparison of mortality rate within 30 days of antibiotic discontinuation	within 30 days of antibiotic discontinuation
Epidemiology of bacteria	Distribution of bacteria responsible for bloodstream infection	at baseline
Risk factors for relapses	Analyse of risk factors for bloodstream infection relapses	within 30 days of antibiotic discontinuation

Collaborators and Investigators

• Sponsor: Poitiers University Hospital
• Investigators: Study Director: France Cazenave-Roblot

Study record dates

Study Major Dates

• Study Start (Actual): January 1, 2020
• Primary Completion (Actual): June 1, 2020
• Study Completion (Actual): June 1, 2020

Study Registration Dates

• First Submitted: May 27, 2021
• First Submitted That Met QC Criteria: June 1, 2021
• First Posted (Actual): June 2, 2021

Study Record Updates

• Last Update Posted (Actual): June 2, 2021
• Last Update Submitted That Met QC Criteria: June 1, 2021
• Last Verified: May 1, 2021

More Information

Terms related to this study

• Keywords: antibiotic short course, appropriate use of antibiotics
• Additional Relevant MeSH Terms: Pathologic Processes; Neoplasms by Histologic Type; Neoplasms; Systemic Inflammatory Response Syndrome; Inflammation; Wounds and Injuries; Disease Attributes; Hematologic Diseases; Agranulocytosis; Leukopenia; Leukocyte Disorders; Body Temperature Changes; Heat Stress Disorders; Sepsis; Infections; Communicable Diseases; Leukemia; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Neutropenia; Hyperthermia; Fever; Febrile Neutropenia; Anti-Infective Agents; Anti-Bacterial Agents
• Other Study ID Numbers: Antibioshort neutropenia

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No