Analysis of the value of empiric vancomycin administration in febrile neutropenia occurring after autologous peripheral blood stem cell transplants

R. Koya, J. Andersen, H. Fernandez, M. Goodman, N. Spector, R. Smith, J. Hanlon, P. A. Cassileth

Research output: Contribution to journalArticle

17 Scopus citations

Abstract

We conducted a retrospective review of 125 patients undergoing high-dose therapy and stem cell rescue in order to evaluate the incidence of documented infection and the utility of the administration of vancomycin empirically. All patients received prophylactic oral quinolone therapy. Because neutropenia in this setting is relatively brief, 21 patients never manifested fever, and no patient died of infection. Of the remaining 104 patients, positive blood cultures were obtained in only 10, nine with a gram stain positive and one with a gram stain negative organism. Sixty-two patients without any evidence of gram positive infection received vancomycin according to the existing algorithm for care of neutropenic fevers. In this population of patients, empiric administration of vancomycin for neutropenic fevers without culture documentation appears to be unnecessary, could be discontinued safely and at substantial cost savings, and might slow the appearance of vancomycin-resistant organisms.

Original languageEnglish (US)
Pages (from-to)923-926
Number of pages4
JournalBone Marrow Transplantation
Volume21
Issue number9
DOIs
StatePublished - May 1 1998

Keywords

  • Autologous stem cell transplant
  • Infections
  • Neutropenic fever
  • Vancomycin

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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