Discontinuation of imipenem-cilastatin or meropenem after 3x24 hours irrespective of presence of fever.

Extended treatment with imipenem-cilastatin or meropenem for at least 6 more days. The treatment with a carbapenem will be continued until patients have been treated for at least 9x24 hours and have been afebrile (tympanic membrane temperature <38.0°C) for at least five consecutive days or until resolution of neutropenia (ANC > 0,5 x10^9/L), whichever comes first.

Febrile Neutropenia

Hematological Malignancy

Discontinuation of imipenem-cilastatin or meropenem

VU university medical center

HAGA ziekenhuis

Short Versus Extended Antibiotic Treatment With a Carbapenem for High-risk Febrile Neutropenia in Hematology Patients With FUO

Short Versus Extended Antibiotic Treatment With a Carbapenem for High-risk Febrile Neutropenia in Hematology Patients With Fever of Unknown Origin: a Randomized Multicenter Non-inferiority Trial.

Treatment failure is defined as the occurrence of one of the following events after 3x24 hours and before 9x24hours after treatment initiation with a carbapenem:
-A clinically or microbiologically documented carbapenem-sensitive infection; treatment.
Recurrence of fever after previous defervescence (tympanic temperature <38.0 °C during 24 hours) which is not attributable to administration of a blood product or to a drug reaction.
o In case of clinical doubt whether the fever is of infectious etiology, the recurrence of fever will be considered as failure.

The occurrence of death, ARDS/respiratory insufficiency, septic shock (systolic blood pressure <90 mmHg and oliguria <500 mL/day) due to any cause.

Treatment strategy failure is defined as occurrence of any of the following events after 3x24hours of treatment with a carbapenem and until the end of the neutropenic episode:
Any clinically or microbiologically documented infection.
The recurrence of fever after previous defervescence during neutropenia.
Death, septic shock or ARDS/respiratory failure due to any cause
Adverse drug-related events due to a carbapenem requiring (temporary) interruption of treatment, including but not exclusively: liver and kidney dysfunction, convulsion and allergic reactions.
Unexpected re-admission within 30 days after discharge other than for planned chemotherapy or other elective treatment.
Antibiotic or antifungal treatment within 30days after discharge other than standard antibiotic prophylaxis.

Fever is defined as one single measured tympanic membrane temperature of >38.5°C or a temperature of >38.0°C during 2 subsequent measurements separated by at least 2 hours.
Defervescence is defined as three times a tympanic membrane temperature <37.5 °C with a minimal measurement interval of at least 8 hours

antipseudomonal/חום

Short Versus Extended Antibiotic Treatment With a Carbapenem for High-risk Febrile Neutropenia in Hematology Patients With FUO

המאגר השלם ביותר של צמחי מרפא המגובה על ידי המדע