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Variation in Antibiotic Prescription in High-Risk Febrile Neutropenia in Portuguese Hospitals

Authors :
Marta Freitas
Paulo Andrade
Ricardo Pinto
Fernanda Trigo
Ana Azevedo
Francisco Almeida
Source :
Antibiotics, Vol 13, Iss 9, p 822 (2024)
Publication Year :
2024
Publisher :
MDPI AG, 2024.

Abstract

Introduction: Febrile neutropenia (FN) is a potentially severe entity, particularly in hemato-oncologic patients who have higher incidence of colonization with multidrug-resistant bacteria. Discrepancies among guidelines contribute to divergence in antimicrobial practices. Our objective was to assess the variation of practices in antimicrobial therapy in high-risk FN among Portuguese hematologists. Methods: We conducted a cross-sectional study through the implementation of an online survey, open to all clinical hematologists in the country. To characterize practice patterns regarding critical elements in FN management, three clinical vignettes were designed to describe typical situations where narrow-spectrum empiric antibiotics (vignette 1), short-course therapy (vignette 2) and de-escalation (vignette 3) could be performed. The remaining questions characterized clinical experience, department size, and differentiation and decision-making process regarding FN antibiotic therapy. Results: The survey yielded 31 responses from 11 hospitals across four regions. All respondents opted for empiric narrow-spectrum antibiotics, 22.6% opted for short-course therapy (mostly senior specialists from larger settings) and 35.5% for de-escalation (mostly young specialists). Availability of an FN protocol seemed to favor both approaches. These findings should be complemented by qualitative assessments of barriers to best practices and should support the need for interventions to improve antibiotic use in febrile neutropenia.

Details

Language :
English
ISSN :
20796382
Volume :
13
Issue :
9
Database :
Directory of Open Access Journals
Journal :
Antibiotics
Publication Type :
Academic Journal
Accession number :
edsdoj.b72f5be0893b4038b5c405b7c0e5ca48
Document Type :
article
Full Text :
https://doi.org/10.3390/antibiotics13090822