TY  - JOUR
A1  - Ballo, Olivier Karl Friedrich
A1  - Kreisel, Eva-Maria
A1  - Eladly, Fagr
A1  - Brunnberg, Uta
A1  - Stratmann, Jan Alexander
A1  - Hunyady, Peter Marton
A1  - Hogardt, Michael
A1  - Wichelhaus, Thomas A.
A1  - Kempf, Volkhard A. J.
A1  - Steffen, Björn
A1  - Vehreschild, Jörg Janne
A1  - Vehreschild, Maria J. G. T.
A1  - Finkelmeier, Fabian
A1  - Serve, Hubert
A1  - Brandts, Christian Hubertus
T1  - Use of carbapenems and glycopeptides increases risk for Clostridioides difficile infections in acute myeloid leukemia patients undergoing intensive induction chemotherapy
T2  - Annals of hematology
N2  - Patients with acute myeloid leukemia (AML) are often exposed to broad-spectrum antibiotics and thus at high risk of Clostridioides difficile infections (CDI). As bacterial infections are a common cause for treatment-related mortality in these patients, we conducted a retrospective study to analyze the incidence of CDI and to evaluate risk factors for CDI in a large uniformly treated AML cohort. A total of 415 AML patients undergoing intensive induction chemotherapy between 2007 and 2019 were included in this retrospective analysis. Patients presenting with diarrhea and positive stool testing for toxin-producing Clostridioides difficile were defined to have CDI. CDI was diagnosed in 37 (8.9%) of 415 AML patients with decreasing CDI rates between 2013 and 2019 versus 2007 to 2012. Days with fever, exposition to carbapenems, and glycopeptides were significantly associated with CDI in AML patients. Clinical endpoints such as length of hospital stay, admission to ICU, response rates, and survival were not adversely affected. We identified febrile episodes and exposition to carbapenems and glycopeptides as risk factors for CDI in AML patients undergoing induction chemotherapy, thereby highlighting the importance of interdisciplinary antibiotic stewardship programs guiding treatment strategies in AML patients with infectious complications to carefully balance risks and benefits of anti-infective agents.
KW  - AML
KW  - CDI
KW  - Induction chemotherapy
Y1  - 2020
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/74544
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-745447
SN  - 1432-0584
N1  - Open Access funding enabled and organized by Projekt DEAL.
VL  - 99
IS  - 11
SP  - 2547
EP  - 2553
PB  - Springer
CY  - Berlin ; Heidelberg ; New York
ER  -