Faith Y. Santos
Dr. Pablo O. Torre Memorial Hospital, Philippines
Title: Compliance with Guideline-Based Empiric Antimicrobial Therapy for Febrile Neutropenia in Adult Filipino Patients and their Effect on Outcomes
Biography
Biography: Faith Y. Santos
Abstract
Background: Febrile Neutropenia (FN) is a common complication of immune-compromised patients; whether due to infection, cancer, drug-induced, or other bone marrow failure states. With the incidence of patients with immune-compromised states on the rise, this life threatening complication is also increasing. The importance of initiating the appropriate empiric antibiotic therapy can prove to be life-saving, thus we examined how the initial choice of antibiotics influenced patient outcomes.
Objective: This study aimed to determine the effect of adherence to guideline-based antimicrobial therapy for adult febrile neutropenia patients in terms of patient outcomes.
Design: Retrospective cross-sectional analytical study.
Methods: This is a 10 year cross-sectional analytical study which was conducted by doing a retrospective chart review involving adult patients with FN from 2007 to 2016. We determined use of guideline-based antibiotics, examined the factors that influenced adherence, and investigated the effect of initial treatment on patient outcome.
Results: Among the 257 adult patients with FN included in the study, guideline-based antibiotics were administered to 65%. On multivariate analysis, the most powerful predictor of adherence to guideline-based antibiotics was the type of risk (p=0.000), with high risk patients thrice more likely to be given guideline-based antibiotics. Other predictors were physician specialty (p=0.036) and hematologic malignancy (p=0.045). This study showed that among low risk patients with FN, a trend towards patient discharge was observed (OR 1.18, CI=0.16–8.63). However overall, adherence to guideline based empiric antibiotic in treating adult FN patients did not correlate to patient discharge (p=0.134, OR 0.557, 95% CI=0.260-1.205).
Conclusion: In summary, our data suggest that adherence to guideline-based antibiotics in managing adult Filipino patients with febrile neutropenia does not correlate to better outcomes such as patient discharge. Significant factors associated with adherence to guideline-based antibiotics are physician specialty, hematologic malignancy and type of risk.