Febrile neutropenia in patients with acute leukemia following chemotherapy: A retrospective review

Febrile neutropenia is a common complication of cancer patients receiving chemotherapy. Empiric treatment with broad-spectrum parenteral antibiotics is important for high-risk patients. A retrospective study to evaluate the infection sources, pathogens and clinical responses of current recommended antibiotics were conducted in patients with acute leukemia complicated with febrile neutropenia. There were 87 episodes of febrile neutropenia related with chemotherapy during Aug. 2003 to Aug. 2004. Piperacillin-, ceftazidime- and cefepime-based antibiotics were the major choices in this study. The clinical response rates were 41%, 35% and 33% respectively, and there were no statistic significance. There were three mortalities (3.4%) and two shock episodes (2.3%). Among 87 episodes, there were 32 culture results (36.8%) including 30 septicemias, one bronchoalveolar lavage and one tissue culture. Gram-negative bacilli were predominant (65.6%) and Escherichia coli was the leading pathogen (34%). Seven gram-positive bacteremia episodes (21.9%) occurred without shock or mortality. Three candida species were isolated including two fatal Candida tropicalis candidemia and one invasive esophageal C. albicans. Our data showed that, for patients with febrile neutropenia in our hospital, there is no statistically significant difference in the response to piperacillin-, ceftazidime-, and cefepime-based empirical antibiotics regimens.