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KMID : 0191120190340020017
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Journal of Korean Medical Science
2019 Volume.34 No. 2 p.17 ~ p.17
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Evaluation of a Carbapenem-Saving Strategy Using Empirical Combination Regimen of Piperacillin-Tazobactam and Amikacin in Hemato-Oncology Patients
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Ko Jae-Hoon
Kim Si-Ho
Kang Cheol-In
Cho Sun-Young
Lee Nam-Yong
Chung Doo-Ryeon
Peck Kyong-Ran
Song Jae-Hoon
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Abstract
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We implemented a carbapenem-saving strategy in hemato-oncology patients from 2013, using an empirical combination of piperacillin-tazobactam and amikacin for high-risk hemato-oncology patients with febrile neutropenia, who remain hemodynamically unstable > 72 hours despite initial cefepime treatment. All-cause mortality was not different between the two periods (6.54 and 6.57 deaths per 1,000 person-day, P = 0.926). Group 2 carbapenem use significantly decreased after strategy implementation (78.43 vs. 67.43 monthly days of therapy, P = 0.018), while carbapenem-resistant gram-negative bacilli did not show meaningful changes during the study period. Our carbapenem-saving strategy could effectively suppress carbapenem use without an increase of overall mortality.
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KEYWORD
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Carbapenem-Saving, Piperacillin-Tazobactam, Amikacin, Gram-Negative Bacilli, Resistance
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