Marissa Duco Butler University
Faculty Sponsor(s): David Reeves Butler UniversityFebrile neutropenia is a complication of cancer treatment and can result in potentially life-threatening infections. Currently there are guidelines directing the empiric use of vancomycin in febrile neutropenia for critical patients with hemodynamic instability. Vancomycin use comes with a risk for toxicities such as renal dysfunction, along with supporting growing resistance in patients who do not prove to have gram-positive infections. The purpose of this study is to evaluate vancomycin use in accordance with guideline recommendations in order to determine potential opportunities for improvement in a population of patients with febrile neutropenia. This retrospective study was conducted as a chart review of 275 patients, and the primary outcome was to determine the proportion of patients meeting criteria for empiric vancomycin use and the proportion of patients appropriately receiving vancomycin. Results showed that 93% of febrile neutropenic patients met criteria and qualified for empiric vancomycin use, but while 86% of patients tested negatively for gram-positive bacteria 90% of them met criteria to receive vancomycin demonstrating that the criteria may not reliably predict gram-positive infection. Guidelines state that discontinuation of vancomycin if a gram-positive infection is not detected should occur within 48 hours, and results discovered that 55% of patients were discontinued appropriately. In conclusion, this study demonstrates a potential need for more exclusive criteria to predict gram-positive infection, and more education for healthcare providers on the appropriate use of vancomycin to increase antibiotic stewardship.
Pharmacy, Health Sciences, & Exercise Science
When & Where
Irwin Library Lower Level