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Evaluation of bloodstream infections in febrile neutropenic patients with hematological malignancy: a retrospective cohort study.

BACKGROUND: Patients with hematological malignancies (HMs) are at high risk of bloodstream infections (BSIs) during episodes of febrile neutropenia (FN). However, empirical treatment initiated before isolation of the causative agent from blood cultures is crucial. The aim of this study was to determine the distribution and antimicrobial resistance profile of microorganisms isolated from BSIs in patients with HMs, and to evaluate the association with the need for intensive care unit (ICU) and mortality at 30 days. METHODS: Single-centre data from patients with HMs who were admitted to the hema

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… Piperacillin-tazobactam was the most frequently initiated empirically therapy, used in 39.0% of BSI episodes, followed by cefepime (15.9%), meropenem (15.2%), and meropenem plus vancomycin (12.8%). …

Редкое дерматологическое проявление фолликулярных смешений у пациента с множественной миеломой и конечной стадией почечной болезни при гемодиализе: отчет по делу.

Множественная миелома (ММ) — гематологическая порча, характеризующаяся клональным расширением злокачественных плазменных клеток в костном мозге, что приводит к различным системным осложнениям. Хотя резкие проявления MM редки, фолликулы представляют собой весьма специфический, но редкий дерматологический вывод, связанный с MM. В настоящем исследовании представлен пример 59-year-old Человек с MM, который демонстрировал фолликулярный акантоз и гиперкератоз в качестве скромных индикаторов злодеяний. Пациент с историей сцены 5 В ходе клинической оценки и лабораторных исследований был диагностирован

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… Pharmacological management comprised of the following: i) Broad-spectrum antibiotics, including piperacillin-tazobactam (4.5 g IV every 8 h) to empirically cover gram-negative and anaerobic pathogens pending culture results; ii) moxifloxacin (400 mg IV once daily) to provide additional coverage for atypical …

Acute kidney injury in cancer patients: A nationwide survey in China.

Cancer patients have a high risk for acute kidney injury (AKI); however, the incidence, severity, and risk factors of malignancy-related AKI (MR-AKI) are unclear. This study aimed to assess MR-AKI risk factors and provide reliable data for AKI prevention, diagnosis, and management in China. This cross-sectional study analysed data from 44 academic and local hospitals in China. AKI patients were identified based on 2 screening criteria: the 2012 Kidney Disease: Improving Global Outcomes-AKI definition and the expanded screening criteria for patients with no repeated serum creatinine (SCr) test

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… Acute Kidney Injury in Hematopoietic Cell Transplantation Patients Receiving Vancomycin and Piperacillin/Tazobactam Versus Vancomycin and Cefepime. …

Clinical Outcome of Febrile Neutropenia and Associated Factors Among Adult Patients with Cancer Treated at Ethiopian Oncology Centers: A Retrospective Observational Study.

IntroductionFebrile neutropenia (FN) is a major cause of dose-limiting complications in cancer treatment that predisposes patients to serious infections. Despite advancements in therapies, including empirical and definitive antibiotics, FN remains a major morbidity and mortality issue among patients with cancer undergoing cancer treatment. Little is known about the 30-day all-cause mortality rates from FN in Ethiopia, particularly in the Northwest Ethiopia oncology centers.MethodsThis retrospective cross-sectional study was conducted via chart review without direct patient contact at two North

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… The extended-spectrum cephalosporins (cefepime or ceftazidime), carbapenems (imipenem or meropenem), and the antipseudomonal penicillin (piperacillin–tazobactam or ticarcillin–clavulanate) are the mainstay of empiric monotherapy or combination therapy among patients with FN [ 7 ]. …

50th ESCP Symposium on Clinical Pharmacy, Polypharmacy and ageing - highly individualized, interprofessional, person-centered care : 19–21 October 2022, Prague, Czech Republic

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… The concentrations of ceftolozane and tazobactam were simultaneously determined using high-performance liquid chromatography. … The typical volume of distribution equaled 20.2L for ceftolozane and 55.4L for tazobactam. The typical clearance equaled 6.37 L/h and 15.5L/h for ceftolozane and tazobactam. No covariates were found to be useful in explaining inter-individual variability of pharmacokinetic parameters. …

Gut microbiota shapes cancer immunotherapy responses.

The gut microbiota significantly influences cancer immunotherapy efficacy by modulating immune responses, remodeling the tumor microenvironment (TME), and producing key metabolites. Strategies such as FMT, probiotics, and dietary interventions show promise in enhancing responses to ICIs and ACTs while reducing immune-related adverse events (irAEs). This review summarizes clinical and preclinical findings and discusses microbiota-based interventions and future directions for precision immunotherapy.

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… In 2022, Lauren et al. found that patients treated with piperacillin/tazobactam, meropenem, or imipenem/cilastatin (P-I-M) antibiotics within four weeks before CD19-targeted CAR-T therapy had lower survival rates and higher neurotoxicity risks. … PD-L1 mAb, αCTLA-4 mAb, or combination treatment 215 Melanoma 568 Cephalosporins; penicillins; fluoroquinolone αPD-1 mAb; αCTLA-4 mAb; combined 216 Lung cancer; etc. 767 Antibiotics αPD-1/αPD-L1 mAb; 217 NSCLC 256 Antibiotics αPD-1/PD-L1 mAb, αCTLA-4 mAb 218 B cell lymphoma; leukemia 228 Piperacillin/tazobactam …

Prevalence, Attributes, and Risk Factors of QT-Interval-Prolonging Drugs and Potential Drug-Drug Interactions in Cancer Patients: A Prospective Study in a Tertiary Care Hospital.

Introduction Cancer chemotherapy regimens include multiple classes of adjuvant drugs as supportive therapy. Because of the concurrent intake of other drugs (like antiemetics, antidepressants, analgesics, and antimicrobials), there is a heightened risk for possible QT interval prolongation. There is a dearth of evidence in the literature regarding the usage of QT-prolonging anticancer drugs and associated risk factors that have the propensity to prolong QT interval. The purpose was to explore the extent of the use of QT-interval-prolonging drugs and potential QT-prolonging drug-drug interaction

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… Possible risk of TdP (n=75) | Ofloxacin (J01RA09) | 73 (5.5) Norfloxacin (J01RA13) | 1 (0.1) Known risk of TdP (n=18) | Ciprofloxacin (J01MA02) | 11 (0.8) Levofloxacin (J01MA12) | 5 (0.3) Azithromycin (J01FA10) | 2 (0.1) Conditional risk of TdP (n=7) | Metronidazole (P01AB01) | 6 (0.4) Piperacillin/Tazobactam …

Fluoroquinolone Prophylaxis Uncovers High Prevalence Rates of Fluoroquinolone-Resistant Enterobacterales Colonization in Multiple Myeloma Autologous Transplant Patients: A Prospective Cohort Study.

Background: Fluoroquinolone prophylaxis during autologous stem cell transplantation (aSCT) reduces the risk of fever but raises the risk of bloodstream infection (BSI) with fluoroquinolone-resistant Enterobacterales (FRE). We performed a prospective cohort study to detect the presence and potential gain or loss of colonic FRE colonization using serial sampling before and after aSCT in a uniform population of patients with a diagnosis of multiple myeloma. Methods: Eligible subjects underwent aSCT after conditioning with dose-intense melphalan, 200 mg/m2. Peri-anal swabs were obtained before aSC

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… Meropenem 1 gm IV q8 h or piperacillin–tazobactam 4.5 gm IV q6 h could be used per physician discretion. Vancomycin was added for patients with known MRSA colonization detected on pre-transplant screening. Empiric treatment continued until neutrophil engraftment and resolution of fever. …

Post-Transplant Cyclophosphamide and Tacrolimus-Mycophenolate Mofetil Combination Governs GVHD and Immunosuppression Need, Reducing Late Toxicities in Allogeneic Peripheral Blood Hematopoietic Cell Transplantation from HLA-Matched Donors.

Combined direct antineoplastic activity and the long-lasting immunological effects of allogeneic hematopoietic cell transplant (HCT) can cure many hematological malignancies, but broad adoption requires non-relapse mortality (NRM) rates and graft-versus-host disease (GVHD) control. Recently, posttransplant cyclophosphamide (PTCy) given after a bone marrow transplant significantly reduced GVHD-incidence, while PTCy given with tacrolimus/mofetil mycophenolate (T/MMF) showed activity following allogeneic peripheral blood stem cell transplantation (alloPBSCT). Here, we report the experience of a l

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… In cases of fever (>38.5 °C), blood and urine cultures were collected and wide-spectrum antibiotic intravenous therapy (i.e., piperacillin/tazobactam at 4.5 g q8 h i.v. and vancomycin at 500 mg q6 h i.v.) was started until pathogens were identified or clinical control achieved. …

Экстренные ситуации в гематологии: Почему, когда и как я лечусь?

Гематологические чрезвычайные ситуации являются критическими медицинскими условиями, требующими неотложного внимания в силу их быстрого развития и опасного для жизни характера. В качестве примера можно привести гиперкальцемию, которая часто ассоциируется с раком, таким как множественная миелома, что может привести к серьезной неврологической и сердечной дисфункции. Гиперлейкоцитоз, распространенный в острой миэлоидной лейкемии, повышает риск лейкостаза и многоорганического отказа. Кислородный кризис, обычное осложнение серповидноклеточной болезни, является результатом вазооккуляции, приводящей

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… Initial therapy typically involves monotherapy with an anti-pseudomonal β-lactam agent, such as cefepime, piperacillin-tazobactam, or carbapenems, which cover a broad range of pathogens. …

Infectious complications after hematopoietic stem cell transplantation: current status and future perspectives in Korea.

Hematopoietic stem cell transplantation (HSCT) is a treatment for hematologic malignancies, immune deficiencies, or genetic diseases, ect. Recently, the number of HSCTs performed in Korea has increased and the outcomes have improved. However, infectious complications account for most of the morbidity and mortality after HSCT. Post-HSCT infectious complications are usually classified according to the time after HSCT: pre-engraftment, immediate post-engraftment, and late post-engraftment period. In addition, the types and risk factors of infectious complications differ according to the stem cell

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… Except for the presence of definite infection foci, the broad-spectrum β-lactam antibiotics ceftazidime, cefepime, piperacillin/tazobactam, and carbapenem are recommended as they have activity against Gram-positive and -negative bacteria, including P. aeruginosa [ 13 , 15 , 43 , 44 ]. …

Management of chimeric antigen receptor T (CAR-T) cell-associated toxicities.

The use of chimeric antigen receptor T (CAR-T) cells is a significant therapeutic improvement increasing the prognosis for patients with a variety of hematological malignancies. However, this therapy has also sometimes life-threatening, complications. Therefore, knowledge of the treatment and management of these complications, especially in treatment centers and intensive care units, respectively, is of outstanding importance. This review provides recommendations for the diagnosis, management, and treatment of CAR-T cell-associated complications such as cytokine release syndrome, immune effect

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… If the focus is unclear, a Pseudomonas-effective antibiotic (piperacillin/tazobactam, imipenem, meropenem, cefepime, or ceftazidime) must be initiated within one hour [ 21 ]. …

When and for Whom Does Intensive Care Unit Admission Change the Prognosis in Oncology?-A Scoping Review.

Background: The intersection between oncology and intensive care has shifted from predominantly end-of-life care to a therapeutic bridge that can preserve anticancer trajectories in carefully selected patients. Yet, criteria separating benefit from futility remain fragmented. Objective: This paper seeks to map contemporary evidence (2015-2025) on outcomes after Intensive Care Unit (ICU) admission in adults with cancer and to identify clinical constellations in which ICU-level care still changes prognosis. Methods: PRISMA-ScR scoping review (PCC framework). PubMed search (2015-2025), dual scree

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… Empirical antibiotics should be chosen according to local ecology (piperacillin/tazobactam or a carbapenem), with an aminoglycoside added in septic shock and de-escalation guided by cultures; early assessment of invasive fungal risk and initiation of antifungal therapy are indicated if instability persists …

Targeting the gut microbiota to enhance the antitumor efficacy and attenuate the toxicity of CAR-T cell therapy: a new hope?

Chimeric antigen receptor (CAR) -T cell therapy has achieved tremendous efficacy in the treatment of hematologic malignancies and represents a promising treatment regimen for cancer. Despite the striking response in patients with hematologic malignancies, most patients with solid tumors treated with CAR-T cells have a low response rate and experience major adverse effects, which indicates the need for biomarkers that can predict and improve clinical outcomes with future CAR-T cell treatments. Recently, the role of the gut microbiota in cancer therapy has been established, and growing evidence

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… Indeed, 60% of the patients received antibiotics, and 20.6% of them specifically received broad-spectrum antibiotics such as piperacillin/tazobactam, imipenem/cilastatin, and meropenem (PIM), which target anaerobic gut commensal bacteria. …

Dietary fungi in cancer immunotherapy: From the perspective of gut microbiota.

Immunotherapies are recently emerged as a new strategy in treating various kinds of cancers which are insensitive to standard therapies, while the clinical application of immunotherapy is largely compromised by the low efficiency and serious side effects. Gut microbiota has been shown critical for the development of different cancer types, and the potential of gut microbiota manipulation through direct implantation or antibiotic-based depletion in regulating the overall efficacy of cancer immunotherapies has also been evaluated. However, the role of dietary supplementations, especially fungal

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… and toxicity following anti-CD19 CAR T cell therapy in B cell malignancy patients, as revealed by distinct bacterial taxa and metabolic pathways in patients treated with/without antibiotics, as well as worse survival and increased neurotoxicity seen in patients exposed to antibiotics (piperacillin/tazobactam …

Mucositis and Infection in Hematology Patients.

Survival in patients with hematological malignancies has improved over the years, both due to major developments in anticancer treatment, as well as in supportive care. Nevertheless, important and debilitating complications of intensive treatment regimens still frequently occur, including mucositis, fever and bloodstream infections. Exploring potential interacting mechanisms and directed therapies to counteract mucosal barrier injury is of the utmost importance if we are to continue to improve care for this increasingly growing patient population. In this perspective, I highlight recent advanc

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… Results of a Multicenter, Controlled, Randomized Clinical Trial Evaluating the Combination of Piperacillin/Tazobactam and Tigecycline in High-Risk Hematologic Patients with Cancer with Febrile Neutropenia J. Clin. Oncol. 2014 32 1463 1471 10.1200/JCO.2013.51.6963 24733807 95. Ziegler I. …

Stem cells for luminal, fistulizing, and perianal inflammatory bowel disease: a comprehensive updated review of the literature.

Much research has been performed over the last decade on stem cell therapy as treatment for patients with inflammatory bowel disease. Hematopoietic and mesenchymal stem cells, both allogeneic (from someone else) and autologous (from own patient), have been studied with safe and efficacious results in the majority of patients treated for luminal, perianal, and/or fistulizing disease. Here in this review, we highlight all human trials that have been conducted utilizing stem cell therapy treatment in patients with inflammatory bowel disease.

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… During this trial, patients were treated with supportive care utilizing ciprofloxacin, fluconazole, metronidazole, acyclovir, and if needed piperacillin/tazobactam for neutropenia. CDAI and CSI were evaluated before, and 6 and 12 months after, and yearly for 5 years after transplantation. …

Machine learning for acute kidney injury: Changing the traditional disease prediction mode.

Acute kidney injury (AKI) is a serious clinical comorbidity with clear short-term and long-term prognostic implications for inpatients. The diversity of risk factors for AKI has been recognized in previous studies, and a series of predictive models have been developed using traditional statistical methods in conjunction with its preventability, but they have failed to meet the expectations in limited clinical applications, the rapid spread of electronic health records and artificial intelligence machine learning technology has brought new hope for the construction of AKI prediction models. In

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… Risk factors for acute kidney injury in vancomycin and piperacillin/tazobactam combination therapy: a retrospective study. J Infect Chemother. (2021) 27:1614–20. 10.1016/j.jiac.2021.07.017 7. Alfano G, Ferrari A, Fontana F, Mori G, Magistroni R, Meschiari M, et al. …

Резюме МКАРЕ 2023 77th Национальный конгресс " СИААРТИ "

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Search for novel biomarkers of febrile neutropenia in hematological patients: an overview.

A single-center prospective study was conducted at a tertiary care hospital in Kuopio Finland over the past two decades, searching for novel biomarker candidates to predict complicated course of febrile neutropenia (FN) in hematological patients. In Dec 2006‒Dec 2015, 85 patients with acute myeloid leukemia and 179 autologous hematopoietic stem cell transplant recipients were included. More than 20 biomarkers were evaluated in subsequent patient cohorts and compared to C-reactive protein (CRP) and procalcitonin (PCT). The samples were taken on d0-d2 from the beginning of FN. Here, we provide a

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… As to AML patients, broad-spectrum antibiotic therapy (third-generation cephalosporin and tobramycin or piperacillin-tazobactam and tobramycin) was started after blood cultures. …