scholarly journals Extended Infusion of Beta-Lactams Is Associated With Improved Outcomes in Pediatric Patients

2021 ◽  
Vol 26 (2) ◽  
pp. 187-193
Author(s):  
Tracy N. Zembles ◽  
Rachael Schortemeyer ◽  
Evelyn M. Kuhn ◽  
Glenn Bushee ◽  
Nathan E. Thompson ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Clinical Outcomes ◽  
Bone Marrow Transplant ◽  
Marrow Transplant ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Beta Lactam ◽  
Beta Lactams ◽  
Transplant Patients ◽  
Extended Infusion

OBJECTIVE The pharmacokinetics of beta-lactam antibiotics favor administration via an extended infusion. Although literature supporting extended infusion beta-lactams exists in adults, few data are available to guide the practice in pediatrics. The purpose of this study was to compare clinical outcomes between extended and standard infusions in children. METHODS This retrospective chart analysis included hospitalized patients 0 to 18 years old who received at least 72 hours of cefepime, piperacillin-tazobactam, or meropenem between October 1, 2017, and March 31, 2019. Clinical outcomes of care included hospital length of stay, readmission within 30 days, and all-cause mortality. RESULTS A total of 551 patients (258 extended infusion, 293 standard infusion) met criteria for evaluation. Clinical outcomes among the entire population were similar. A subanalysis of select populations demonstrated decreased mortality in critical care patients (2.1% vs 19.6%, p = 0.006) and decreased 30-day readmission rates in bone marrow transplant patients (0% vs 50%, p = 0.012) who received the extended infusion compared with a standard infusion. CONCLUSIONS Outcomes were similar between extended and standard infusions in children. Subgroup analyses suggest a possible mortality benefit in the critically ill and decreased readmission rate in bone marrow transplant patients.

Effect of clinical outcomes data on intensive care unit utilization by bone marrow transplant patients

1998 ◽  
Vol 26 (1) ◽  
pp. 66-70 ◽  
Author(s):  
Harold L. Paz ◽  
Allan Garland ◽  
Martha Weinar ◽  
Pamela Crilley ◽  
Isadore Brodsky
Keyword(s):  
Intensive Care Unit ◽  
Bone Marrow ◽  
Intensive Care ◽  
Clinical Outcomes ◽  
Bone Marrow Transplant ◽  
Marrow Transplant ◽  
Transplant Patients

scholarly journals 254. Review of Clinical Outcomes in Patients Treated with Beta-lactam vs Non-beta-lactam Therapy for AmpC Producing Bacterial Bloodstream Infections

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S126-S126
Author(s):  
Mary L Staicu ◽  
Tyler Baumeister ◽  
Maryrose R Laguio-Vila
Keyword(s):  
Length Of Stay ◽  
Clinical Outcomes ◽  
Bloodstream Infections ◽  
Hospital Length ◽  
Primary Objective ◽  
Hospital Length Of Stay ◽  
Beta Lactam ◽  
Beta Lactams ◽  
Fluoroquinolone Antibiotics ◽  
Significant Difference

Abstract Background AmpC beta-lactamase producing organisms are traditionally treated with carbapenem or fluoroquinolone antibiotics. Recent studies, however, describe similar clinical outcomes in patients that receive cefepime or piperacillin/tazobactam. We sought to assess outcomes in patients with bloodstream infections caused by AmpC-producing organisms that received beta-lactams compared non-beta-lactam therapy. Methods Data was obtained retrospectively from the electronic health record (EHR) from January 2012 to February 2020. The primary objective was 30-day mortality from the day of first positive blood cultures with Enterobacter spp., Citrobacter spp., or Serratia spp. in patients who received non-beta-lactam therapy (carbapenem, fluoroquinolone, trimethoprim/sulfamethoxazole) to those who received beta-lactam therapy (cefepime, piperacillin/tazobactam). Secondary objectives included 30-day recurrence of bacteremia, pathogen isolated, source of bacteremia, hospital length of stay, and duration of antimicrobial therapy. Results A total of 90 patients were included, 50 in the non-beta lactam group and 40 in the beta-lactam group. Demographics were similar between groups. Thirty-day mortality was significantly higher in the beta-lactam group (20% vs 2%, p=0.009). Enterobacter spp. was the most frequently identified pathogen (67%), most commonly isolated from a urinary (31%) or intra-abdominal source (22%). The average duration of antibiotic therapy was significantly higher in the non-beta lactam group (18 vs 12 days, p=0.001). In contrast, there was no significant difference found in hospital length of stay, recurrence of bacteremia, pathogen isolated or source of bacteremia between groups. Conclusion Beta-lactam therapy for the treatment of bloodstream infections caused by Amp-C producing organisms was associated with significantly greater 30-day mortality compared to patients that received non-beta-lactam therapy. Disclosures All Authors: No reported disclosures

Total Hip Arthroplasty in Very Young Bone Marrow Transplant Patients

2015 ◽  
Vol 24 (02) ◽  
Author(s):  
Cameron K. Ledford ◽  
Alexander R. Vap ◽  
Michael P. Bolognesi ◽  
Samuel S. Wellman
Keyword(s):  
Bone Marrow ◽  
Total Hip Arthroplasty ◽  
Bone Marrow Transplant ◽  
Hip Arthroplasty ◽  
Marrow Transplant ◽  
Total Hip ◽  
Transplant Patients

Monitoring Cardiotoxicity in Bone Marrow Transplant Patients With Prior Anthracycline (AC) Therapy

2021 ◽  
Vol 30 ◽  
pp. S198-S199
Author(s):  
P. Emerson ◽  
S. Mahendran ◽  
L. Stefani ◽  
T. Deshmukh ◽  
S. Trivedi ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Transplant ◽  
Marrow Transplant ◽  
Transplant Patients

scholarly journals Detection of Human Polyomaviruses in Urine from Bone Marrow Transplant Patients: Comparison of Electron Microscopy with PCR

2004 ◽  
Vol 50 (2) ◽  
pp. 306-312 ◽  
Author(s):  
Stefan S Biel ◽  
Andreas Nitsche ◽  
Andreas Kurth ◽  
Wolfgang Siegert ◽  
Muhsin Özel ◽  
...  
Keyword(s):  
Electron Microscopy ◽  
Bone Marrow ◽  
Real Time ◽  
Bone Marrow Transplant ◽  
Real Time Pcr ◽  
Marrow Transplant ◽  
Test System ◽  
Urine Samples ◽  
Clinical Samples ◽  
Transplant Patients

Abstract Background: We studied electron microscopy (EM) as an appropriate test system for the detection of polyomavirus in urine samples from bone marrow transplant patients. Methods: We evaluated direct EM, ultracentrifugation (UC) before EM, and solid-phase immuno-EM (SPIEM). The diagnostic accuracy of EM was studied by comparison with a real-time PCR assay on 531 clinical samples. Results: The detection rate of EM was increased by UC and SPIEM. On 531 clinical urine samples, the diagnostic sensitivity of EM was 47% (70 of 149) with a specificity of 100%. We observed a linear relationship between viral genome concentration and the proportion of urine samples positive by EM, with a 50% probability for a positive EM result for urine samples with a polyomavirus concentration of 106 genome-equivalents (GE)/mL; the probability of a positive EM result was 0% for urine samples with <103 GE/mL and 100% for urine samples containing 109 GE/mL. Conclusions: UC/EM is rapid and highly specific for polyomavirus in urine. Unlike real-time PCR, EM has low sensitivity and cannot quantify the viral load.

Sign in / Sign up

Export Citation Format

Share Document