Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/19551
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dc.contributor.authorGrigg, Samuel E-
dc.contributor.authorDate, Patrick-
dc.contributor.authorLoh, Zoe-
dc.contributor.authorEstacio, Ortis-
dc.contributor.authorJohnson, Douglas F-
dc.contributor.authorHawkes, Eliza A-
dc.contributor.authorGrigg, Andrew P-
dc.date2018-09-27-
dc.date.accessioned2018-10-11T02:50:04Z-
dc.date.available2018-10-11T02:50:04Z-
dc.date.issued2018-09-27-
dc.identifier.citationSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer 2018; online first: 27 September-
dc.identifier.urihttps://ahro.austin.org.au/austinjspui/handle/1/19551-
dc.description.abstractThere is a paucity of data regarding the utility of routine urine cultures in adults with febrile neutropenia (FN) without urinary symptoms receiving protocolised antibiotics. This is reflected by inconsistent recommendations in international and regional FN guidelines. We addressed this issue by retrospectively reviewing the impact of routine urine cultures on antibiotic management in haematology cancer inpatients at a tertiary hospital. All haematology inpatients over a 5-year period (2011-2015) were retrospectively reviewed for episodes of FN (neutrophil count < 0.5 × 109/L and fever > 37.5 °C). For each episode, demographic data, urinary tract symptoms and signs (absence of which was termed 'asymptomatic'), urinalysis and urine culture results, antibiotic therapy and duration, and patient outcomes were collected. A urine culture was considered positive if > 105 colony forming units (CFU)/L were detected. Empiric antibiotic therapy for FN consisted of intravenous piperacillin/tazobactam in stable patients, with the addition of vancomycin and a single dose of gentamicin if systemically compromised. Four hundred and thirty-three episodes of FN were identified in 317 patients. Urine cultures were performed in 362 (84%) episodes. Cultures were positive in 9 of 48 (19%) symptomatic episodes versus 8 of 314 (2.5%) asymptomatic episodes (RR = 7.4, p < 0.0001). A change in antibiotic management due a positive urine culture occurred in only 5 episodes (1.4%): 3 of 48 (6.3%) symptomatic and 2 of 314 (0.6%) asymptomatic episodes respectively (RR = 9.8, p = 0.01). Routine urine cultures in FN patients without urinary symptoms who are already receiving protocolised broad spectrum antibiotics rarely impact subsequent antibiotic management.-
dc.language.isoeng-
dc.subjectAntibiotics-
dc.subjectCancer-
dc.subjectFebrile neutropenia-
dc.subjectHaematological malignancy-
dc.subjectUrine culture-
dc.titleUrine cultures at the onset of febrile neutropenia rarely impact antibiotic management in asymptomatic adult cancer patients.-
dc.typeJournal Article-
dc.identifier.journaltitleSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer-
dc.identifier.affiliationOlivia Newton-John Cancer Research Institute, Heidelberg, Victoria, Australiaen
dc.identifier.affiliationDepartment of Clinical Haematology, Austin Health, Heidelberg, Victoria, Australiaen
dc.identifier.affiliationUniversity of Melbourne, Parkville, Victoria, Australiaen
dc.identifier.affiliationDepartment of Infectious Diseases, Austin Health, Heidelberg, Victoria, Australiaen
dc.identifier.affiliationDepartment of Medicine, Austin Health, Heidelberg, Victoria, Australiaen
dc.identifier.doi10.1007/s00520-018-4476-7-
dc.identifier.orcid0000-0001-5743-3171-
dc.identifier.orcid0000-0002-6116-6595en
dc.identifier.orcid0000-0002-9215-1441en
dc.identifier.orcid0000-0002-0376-2559en
dc.identifier.pubmedid30259115-
dc.type.austinJournal Article-
local.name.researcherGrigg, Andrew P
item.openairetypeJournal Article-
item.openairecristypehttp://purl.org/coar/resource_type/c_18cf-
item.grantfulltextnone-
item.fulltextNo Fulltext-
item.cerifentitytypePublications-
item.languageiso639-1en-
crisitem.author.deptGeneral Medicine-
crisitem.author.deptOlivia Newton-John Cancer Wellness and Research Centre-
crisitem.author.deptClinical Haematology-
crisitem.author.deptOlivia Newton-John Cancer Wellness and Research Centre-
crisitem.author.deptOlivia Newton-John Cancer Research Institute-
crisitem.author.deptOlivia Newton-John Cancer Wellness and Research Centre-
crisitem.author.deptClinical Haematology-
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