For Managing Neutropenic Septic Shock, Beta-Lactam plus Amikacin May Be Best

Inappropriate antibiotic treatment raised risk for death in neutropenic patients with bacteremia, but combinations with beta-lactam protected against mortality.

As antibiotic resistance rises in gram-negative bacilli, so too does the difficulty of providing appropriate empiric antibiotic therapy, placing neutropenic patients with bacteremia at excess risk for death. In this retrospective study in Spain, Chumbita and colleagues assessed risk factors for mortality (including various empiric antibiotic therapies) in 1563 patients with neutropenia and bacteremia presenting with or without septic shock (257 and 1306 episodes, respectively).

Thirty-day mortality was 55% versus 15% in patients with or without septic shock. Among septic shock cases, causative pathogens were gram-negative bacilli (81%), gram-positive cocci (22%), and Candida spp. (5%); among these cases, 17% received inappropriate initial an…

Reviewing Author

George Sakoulas, MD

Disclosures

Consultant/Advisory BoardParatek Pharmaceuticals; Nestle Corp.; AbbVie; Shionogi

Speaker’s BureauAllergan/AbbVie; Paratek Pharmaceuticals; Nestle Corp.

RoyaltiesUpToDate

Editorial BoardsAntimicrobial Agents and Chemotherapy; Open Forum Infectious Diseases