J Korean Med Sci.  2019 Jan;34(2):e17. 10.3346/jkms.2019.34.e17.

Evaluation of a Carbapenem-Saving Strategy Using Empirical Combination Regimen of Piperacillin-Tazobactam and Amikacin in Hemato-Oncology Patients

• Ko JH
• Kim SH
• Kang CI
• Cho SY
• Lee NY
• Chung DR
• Peck KR
• Song JH

• KMID: 2440163
• DOI: http://doi.org/10.3346/jkms.2019.34.e17

Abstract

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.

Keyword

Carbapenem-Saving; Piperacillin-Tazobactam; Amikacin; Gram-Negative Bacilli; Resistance

MeSH Terms

Amikacin*
Febrile Neutropenia
Humans
Mortality
Amikacin