Tehran University of Medical Sciences

Science Communicator Platform

Stay connected! Follow us on X network (Twitter):
Share By
Adherence to Practice Guidelines for the Management of Febrile Neutropenia in Patients Undergoing Hematopoietic Stem Cell Transplantation: An Observational Study in a Referral Center in Iran Publisher Pubmed



Ekhtiari Kolour SR1 ; Shahrami B1 ; Kargar M2 ; Taghvaye Masoumi H3 ; Amini S1 ; Vaezi M4 ; Hadjibabaie M1 ; Mohammadi M5 ; Sadeghi K1
Authors

Source: Journal of Oncology Pharmacy Practice Published:2023


Abstract

Introduction: Patients undergoing hematopoietic stem cell transplantation (HSCT) are suspected to develop febrile neutropenia (FN) and severe infections. Therefore, appropriate prescription of antibiotics in these patients is crucial to reduce the rates of morbidity, mortality, and antimicrobial resistance. The present study aimed to evaluate the physicians’ prescription and adherence to the FN clinical guidelines among patients undergoing HSCT. Methods: This prospective observational single-center study was conducted during a 15-month period in a tertiary referral hospital in Iran. The patients with at least one episode of FN following HSCT were included in the current study. The physicians’ adherence to the Infectious Diseases Society of America (IDSA) and National Comprehensive Cancer Network (NCCN) clinical guidelines for the management of FN was evaluated using prescription data and medical record reviews. Results: Two hundred and fifteen patients with 297 FN episodes were evaluated. The timing of antibiotics and the selection of the initial regimen were considered guideline-based therapy. However, antibiotic dosing and initial regimen modification were not followed in terms of the guideline recommendations in 58.1% of the patients. In particular, vancomycin was inappropriately given in 83.1% of patients. The overall adherence of physicians to the guidelines was 35.8%. Conclusion: Non-adherence to clinical guidelines is high particularly in initial regimen modification and administration of vancomycin, which affects hospital stay and patient's outcome. Implementation of guideline-review sessions to raise the awareness of the physicians and to improve the rational use of antimicrobial agents may be crucial. © The Author(s) 2022.
1. Antibiotic Therapy in Sepsis: No Next Time for a Second Chance!, Journal of Clinical Pharmacy and Therapeutics (2021)
2. Azithromycin for Prevention of Graft-Versus-Host Disease: A Randomized Placebo-Controlled Trial, International Journal of Hematology-Oncology and Stem Cell Research (2018)
Experts (# of related papers)
Other Related Docs