Akademik Veri Yönetim Sistemi
Medical Journal of Bakirkoy, cilt.21, sa.2, ss.134-140, 2025 (ESCI)
Objective: To evaluate the outcomes of C-reactive protein (CRP) guided empirical antibiotic therapy versus standardized neutropenic fever approach in patients undergoing autologous stem cell transplantation. Methods: Group 1 (n=133) comprised patients who were administered triple combination antibiotic treatment when their plasma CRP levels doubled. Group 2 (n=117) composed of patients who received guideline-based triple combination antibiotic treatment only when fever was detected during neutropenia. Results: The median duration of neutropenia was 7 days in group 1 (3-18) and group 2 (4-21). The median length of hospital stay was 20 days for group 1 and 18 days for group 2, with similar durations. Fever was encountered in 64.7% of patients within group 1. The median duration of antibiotic therapy until discharge was 9 days in group 1 and 10 days in group 2, with no significant difference observed (p=0.212). One patient in group 1 died, and two patients in group 2 died due to sepsis. In patients who were diagnosed with lymphoma, the median value of the duration of antibiotic therapy until discharge was 10 days in group 1 and 14 days in group 2 (p<0.05). Conclusion: Our findings demonstrate that empirical antibiotic initiation in this patient group was not beneficial in terms of duration of hospital stay, engraftment periods, duration of antibiotic treatment, and mortality rates. While the strategy was non-inferior to the standardized approach, further research is required for risk stratification and implementation, especially in frail patients with specific diagnoses and comorbidities.