Procalcitonin Guiding Antimicrobial Therapy Duration in Febrile Cancer Patients with Documented Infection or Neutropenia

Hanine El Haddad,Issam Raad,Ammar Yousif,Mary Jordan,Anne-Marie Chaftari,Patrick Chaftari,Ray Hachem,Sammy Raad,Ying Jiang,Majd Michael

doi:10.1038/s41598-018-19616-3

Hanine El Haddad, Issam Raad + Show 8 more

Open Access

https://doi.org/10.1038/s41598-018-19616-3

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Abstract

In this analysis, we identified febrile cancer patients with documented infections or neutropenia, whose procalcitonin levels are low at baseline or decrease on antibiotics. These patients had similar outcomes in terms of mortality and relapse of infection regardless of the duration of antimicrobial therapy (less or more than 7 days).

Highlights

We identified febrile cancer patients with documented infections or neutropenia, whose procalcitonin levels are low at baseline or decrease on antibiotics
From July 2009 until June 2011, we identified 575 febrile cancer patients with available PCT levels that presented to the Emergency department or were admitted to MD Anderson Cancer Center
Our study shows that a selected group of febrile cancer patients, those with a low baseline PCT or a PCT that decreases with appropriate therapy might not require prolonged antimicrobial therapy beyond 7 days

Summary

Introduction

We identified febrile cancer patients with documented infections or neutropenia, whose procalcitonin levels are low at baseline or decrease on antibiotics These patients had similar outcomes in terms of mortality and relapse of infection regardless of the duration of antimicrobial therapy (less or more than 7 days). The management of febrile cancer patients could be challenging These patients frequently do not present with typical clinical syndromes and have multiple simultaneous sources of infectious and non-infectious causes of fever. Procalcitonin (PCT) is a hormokine that has been studied in the general population to guide antimicrobial duration in the intensive care unit (ICU) as well as initiation of antibiotics in lower respiratory tract infections[4,5,6] The patients were selected based on their PCT levels to help explore the applicability of a PCT based algorithm in guiding antimicrobial duration in cancer patients and febrile neutropenia

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