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European survey on the use of antibacterial prophylaxis in neutropenic cancer patients: a joint project of the EORTC and the EBMT

Abstract number: 1733_223

Akan H., Marchetti O., Cordonnier C., Calandra for the Infectious Diseases Group of the European Organization for Research T., Cancer Treatment of

Background: Bacterial infections are frequently observed in neutropenic cancer patients. The use of antibacterial prophylaxis (Px) for prevention of these complications may differ among centres due to the emergence of bacterial resistance and the uncertain impact on infectious morbidity and mortality. Few data are available on the use of antibacterial Px in onco-haematological patients in Europe.

Objective: To conduct an European survey on the use of antibacterial Px in neutropenic cancer patients.

Methods: A questionnaire on antibacterial prophylaxis was distributed in 2004–2005 to all members of the EORTC-IDG and EBMT-IDWP. Four clinical settings were studied: short-duration neutropenia (<10 d) in solid tumours/haematological malignancies, long-lasting neutropenia (>10 d) in acute leukaemia, autologous hematopoietic stem cell transplant (HSCT) and allogeneic HSCT.

Results: 105 out of 586 EBMT centres reached by web page and 32 EORTC-IDG members reached by e-mail (70% university, 16% university-affiliated and 14% community or private hospitals) from 25 European countries participated in the survey. Specialties of investigators were: 86% haematology–oncology, 9% infectious diseases, and 5% other. 62% of responding investigators were involved in patients care as primary physicians, 26% as consultants, while 12% were not in charge of this type of patients. Assessment of the risk of bacterial infections and use of antibacterial prophylaxis in the 4 patient populations. Median (range) daily dose of ciprofloxacin: 1000 mg (500–1500). Px was given orally in 100% of the patients with neutropenia < or > 10 days and in autologous HSCT, while it was given i.v. in 6.5% of allogeneic HSCT.

 NeutropeniaHSCT
<10 d (n = 97)>10 d (n = 101)Autologous (n = 101)Allogeneic (n = 100)  
Proportion of investigators estimating that patients are at high risk of bacterial infections9%78%51%80%
Proportion of patients receiving antibacterial Px19%51%50%76%
Antibiotics used for Px:
  Ciprofloxacin55%52%56%53%
  Other fluoroquinolone19%20%18%22%
  Cotrimoxazole23%15%18%22%
  Selective digestive decontamination3%10%7%11%

Conclusions: In Europe, antibacterial prophylaxis is used routinely in 50% to 76% of neutropenic cancer patients with long-duration neutropenia. Oral fluoroquinolones, mostly ciprofloxacin, are the agents used most commonly.

Session Details

Date: 31/03/2007
Time: 00:00-00:00
Session name: European Society of Clinical Microbiology and Infectious Diseases
Subject:
Location: ICC, Munich, Germany
Presentation type:
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