Journal Article

Current Antimicrobial Usage for the Management of Infections in Leukemic Patients in Japan: Results of a Survey

Minoru Yoshida and Ryuzo Ohno

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 39, issue Supplement_1, pages S11-S14
Published in print July 2004 | ISSN: 1058-4838
Published online July 2004 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/383044
Current Antimicrobial Usage for the Management of Infections in Leukemic Patients in Japan: Results of a Survey

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We report the findings of a questionnaire distributed by the Committee of Supportive Care of the Japan Adult Leukemia Study Group to 196 hospitals throughout Japan. For antimicrobial prophylaxis, the oral quinolones are prescribed by 38% of physicians and polymixin B by 31%. For antifungal prophylaxis, amphotericin B is prescribed by 42% of physicians and fluconazole by 41%. Febrile neutropenia is empirically treated with cephalosporin or carbapenem monotherapy by 35% of physicians. Overall, dual therapy (i.e., an aminoglycoside plus a cephalosporin, a carbapenem, or an antipseudomonal penicillin) is prescribed by 50% of physicians. When response to initial empirical therapy does not occur after 3–4 days, 51% of physicians add an antifungal agent; fluconazole is preferred to amphotericin B (prescribed by 66% vs. 28% of physicians). For the treatment of fungemia due to Candida albicans, fluconazole was prescribed by 59% of physicians in cases of stable disease and amphotericin B was prescribed by 57% of physicians in cases of unstable disease. Amphotericin B is selected to treat invasive aspergillosis, but a dose of 0.5–0.7 mg/kg, inadequate for this disease, is prescribed by 44% of physicians. Granulocyte colony-stimulating factor is prescribed to treat patients with acute myelogenous leukemia who have life-threatening infections (27% of physicians) or who have clinically or microbiologically documented infections (26% of physicians).

Journal Article.  1436 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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