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For: Chaftari P, Chaftari AM, Hachem R, Yeung SCJ, Dagher H, Jiang Y, Malek AE, Dailey Garnes N, Mulanovich VE, Raad I. The role of procalcitonin in identifying high-risk cancer patients with febrile neutropenia: A useful alternative to the multinational association for supportive care in cancer score. Cancer Med 2021;10:8475-8482. [PMID: 34725958 PMCID: PMC8633259 DOI: 10.1002/cam4.4355] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 09/22/2021] [Accepted: 10/03/2021] [Indexed: 12/18/2022] Open

For:	Chaftari P, Chaftari AM, Hachem R, Yeung SCJ, Dagher H, Jiang Y, Malek AE, Dailey Garnes N, Mulanovich VE, Raad I. The role of procalcitonin in identifying high-risk cancer patients with febrile neutropenia: A useful alternative to the multinational association for supportive care in cancer score. Cancer Med 2021;10:8475-8482. [PMID: 34725958 PMCID: PMC8633259 DOI: 10.1002/cam4.4355] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 09/22/2021] [Accepted: 10/03/2021] [Indexed: 12/18/2022] Open

Number

Cited by Other Article(s)

Dagher H, Chaftari AM, Hachem R, Jiang Y, Philip A, Mulanovich P, Haddad A, Lamie P, Wilson Dib R, John TM, Dailey Garnes NJM, Ali S, Chaftari P, Raad II. Procalcitonin Level Monitoring in Antibiotic De-Escalation and Stewardship Program for Patients with Cancer and Febrile Neutropenia. Cancers (Basel) 2024;16:3450. [PMID: 39456544 PMCID: PMC11506002 DOI: 10.3390/cancers16203450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2024] [Revised: 09/26/2024] [Accepted: 10/09/2024] [Indexed: 10/28/2024] Open

Affiliation(s)

Hiba Dagher Department of Infectious Diseases, Infection Control, and Employee Health, The University of Texas MD Anderson Cancer Center, 1400 Pressler St., FCT12-6043, Unit 1460, Houston, TX 77030, USA; (H.D.); (R.H.); (Y.J.); (A.P.); (P.M.); (A.H.); (R.W.D.); (T.M.J.); (N.J.M.D.G.); (S.A.); (I.I.R.)
Anne-Marie Chaftari Department of Infectious Diseases, Infection Control, and Employee Health, The University of Texas MD Anderson Cancer Center, 1400 Pressler St., FCT12-6043, Unit 1460, Houston, TX 77030, USA; (H.D.); (R.H.); (Y.J.); (A.P.); (P.M.); (A.H.); (R.W.D.); (T.M.J.); (N.J.M.D.G.); (S.A.); (I.I.R.)
Ray Hachem Department of Infectious Diseases, Infection Control, and Employee Health, The University of Texas MD Anderson Cancer Center, 1400 Pressler St., FCT12-6043, Unit 1460, Houston, TX 77030, USA; (H.D.); (R.H.); (Y.J.); (A.P.); (P.M.); (A.H.); (R.W.D.); (T.M.J.); (N.J.M.D.G.); (S.A.); (I.I.R.)
Ying Jiang Department of Infectious Diseases, Infection Control, and Employee Health, The University of Texas MD Anderson Cancer Center, 1400 Pressler St., FCT12-6043, Unit 1460, Houston, TX 77030, USA; (H.D.); (R.H.); (Y.J.); (A.P.); (P.M.); (A.H.); (R.W.D.); (T.M.J.); (N.J.M.D.G.); (S.A.); (I.I.R.)
Ann Philip Department of Infectious Diseases, Infection Control, and Employee Health, The University of Texas MD Anderson Cancer Center, 1400 Pressler St., FCT12-6043, Unit 1460, Houston, TX 77030, USA; (H.D.); (R.H.); (Y.J.); (A.P.); (P.M.); (A.H.); (R.W.D.); (T.M.J.); (N.J.M.D.G.); (S.A.); (I.I.R.)
Patricia Mulanovich Department of Infectious Diseases, Infection Control, and Employee Health, The University of Texas MD Anderson Cancer Center, 1400 Pressler St., FCT12-6043, Unit 1460, Houston, TX 77030, USA; (H.D.); (R.H.); (Y.J.); (A.P.); (P.M.); (A.H.); (R.W.D.); (T.M.J.); (N.J.M.D.G.); (S.A.); (I.I.R.)
Andrea Haddad Department of Infectious Diseases, Infection Control, and Employee Health, The University of Texas MD Anderson Cancer Center, 1400 Pressler St., FCT12-6043, Unit 1460, Houston, TX 77030, USA; (H.D.); (R.H.); (Y.J.); (A.P.); (P.M.); (A.H.); (R.W.D.); (T.M.J.); (N.J.M.D.G.); (S.A.); (I.I.R.)
Peter Lamie Department of Hospital Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA;
Rita Wilson Dib Department of Infectious Diseases, Infection Control, and Employee Health, The University of Texas MD Anderson Cancer Center, 1400 Pressler St., FCT12-6043, Unit 1460, Houston, TX 77030, USA; (H.D.); (R.H.); (Y.J.); (A.P.); (P.M.); (A.H.); (R.W.D.); (T.M.J.); (N.J.M.D.G.); (S.A.); (I.I.R.)
Teny M. John Department of Infectious Diseases, Infection Control, and Employee Health, The University of Texas MD Anderson Cancer Center, 1400 Pressler St., FCT12-6043, Unit 1460, Houston, TX 77030, USA; (H.D.); (R.H.); (Y.J.); (A.P.); (P.M.); (A.H.); (R.W.D.); (T.M.J.); (N.J.M.D.G.); (S.A.); (I.I.R.)
Natalie J. M. Dailey Garnes Department of Infectious Diseases, Infection Control, and Employee Health, The University of Texas MD Anderson Cancer Center, 1400 Pressler St., FCT12-6043, Unit 1460, Houston, TX 77030, USA; (H.D.); (R.H.); (Y.J.); (A.P.); (P.M.); (A.H.); (R.W.D.); (T.M.J.); (N.J.M.D.G.); (S.A.); (I.I.R.)
Shahnoor Ali Department of Infectious Diseases, Infection Control, and Employee Health, The University of Texas MD Anderson Cancer Center, 1400 Pressler St., FCT12-6043, Unit 1460, Houston, TX 77030, USA; (H.D.); (R.H.); (Y.J.); (A.P.); (P.M.); (A.H.); (R.W.D.); (T.M.J.); (N.J.M.D.G.); (S.A.); (I.I.R.)
Patrick Chaftari Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA;
Issam I. Raad Department of Infectious Diseases, Infection Control, and Employee Health, The University of Texas MD Anderson Cancer Center, 1400 Pressler St., FCT12-6043, Unit 1460, Houston, TX 77030, USA; (H.D.); (R.H.); (Y.J.); (A.P.); (P.M.); (A.H.); (R.W.D.); (T.M.J.); (N.J.M.D.G.); (S.A.); (I.I.R.)

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Dimitrijević J, Čalamać M, Đurmez O, Krstić D, Stojanović M. Serum Albumin as a Prognostic Biomarker for Febrile Neutropenia Outcome and Complications: A Prospective Observational Trial. Clin Med Insights Oncol 2024;18:11795549241281330. [PMID: 39323980 PMCID: PMC11423384 DOI: 10.1177/11795549241281330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 08/19/2024] [Indexed: 09/27/2024] Open

Cossey J, Cote MCB. Evaluation and management of febrile neutropenia in patients with cancer. JAAPA 2024;37:16-20. [PMID: 38980295 DOI: 10.1097/01.jaa.0000000000000054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/10/2024]

Dagher H, Chaftari AM, Mulanovich P, Jiang Y, Hachem R, Malek AE, Borjan J, Viola GM, Raad I. Procalcitonin for antimicrobial stewardship among cancer patients admitted with COVID-19. eLife 2022;11:81151. [PMID: 36541589 PMCID: PMC9788806 DOI: 10.7554/elife.81151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 12/13/2022] [Indexed: 12/24/2022] Open

Abstract

Background

Procalcitonin (PCT) has been used to guide antibiotic therapy in bacterial infections. We aimed to determine the role of PCT in decreasing the duration of empiric antibiotic therapy among cancer patients admitted with COVID-19.

Methods

This retrospective study included cancer patients admitted to our institution for COVID-19 between March 1, 2020, and June 28, 2021, with a PCT test done within 72 hr after admission. Patients were divided into two groups: PCT <0.25 ng/ml and PCT ≥0.25 ng/ml. We assessed pertinent cultures, antibacterial use, and duration of empiric antibacterial therapy.

Results

The study included 530 patients (median age, 62 years [range, 13-91]). All the patients had ≥1 culture test within 7 days following admission. Patients with PCT <0.25 ng/ml were less likely to have a positive culture than were those with PCT ≥0.25 ng/ml (6% [20/358] vs. 17% [30/172]; p<0.0001). PCT <0.25 ng/ml had a high negative predictive value for bacteremia and 30 day mortality. Patients with PCT <0.25 ng/ml were less likely to receive intravenous (IV) antibiotics for >72 hr than were patients with PCT ≥0.25 ng/ml (45% [162/358] vs. 69% [119/172]; p<0.0001). Among patients with PCT <0.25 ng/ml and negative cultures, 30 day mortality was similar between those who received IV antibiotics for ≥72 hr and those who received IV antibiotics for shorter durations (2% [2/111] vs. 3% [5/176], p=0.71).

Conclusions

Among cancer patients with COVID-19, PCT level <0.25 ng/ml is associated with lower likelihood of bacterial co-infection and greater likelihood of a shorter antibiotic course. In patients with PCT level <0.25 ng/ml and negative cultures, an antibiotic course of >72 hr may not be necessary. PCT could be useful in enhancing antimicrobial stewardship in cancer patients with COVID-19.

Funding

This research was supported by the National Institutes of Health/National Cancer Institute under award number P30CA016672, which supports MD Anderson Cancer Center's Clinical Trials Office.

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