Real-world management of infection during chemotherapy for acute leukemia in Japan: from the results of a nationwide questionnaire-based survey by the Japan Adult Leukemia Study Group
Real-world management of infection during chemotherapy for acute leukemia in Japan: from the results of a nationwide questionnaire-based survey by the Japan Adult Leukemia Study Group
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DOI：
10.1007/s12185-020-02921-x
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发表时间：
2020-06-18
影响因子：
2.1
通讯作者：
Miyazaki, Yasushi
中科院分区：
文献类型：
--
作者：
Kimura, Shun-ichi;Fujita, Hanako;Miyazaki, Yasushi
继 2001 年、2007 年和 2013 年调查之后，我们于 2019 年进行了全国范围的问卷调查，以澄清日本急性白血病化疗期间感染的现实管理情况。 2019年6月，通过SurveyMonkey(R)向日本成人白血病研究组成员机构发送了一份在线调查问卷。调查问卷由52个多项选择题组成，内容涵盖急性白血病强化化疗期间的预防措施、筛查和诊断测试、经验性抗生素治疗、抗真菌管理、粒细胞集落刺激因子的使用以及流感和肺炎球菌疫苗的接种。还包括与抗菌药物管理相关的问题。 218 家机构中的 163 家 (74.8%) 收到了可用的答复。大约一半（52.2%）的机构没有传染病科。作为预防性抗生素，氟喹诺酮类药物（62%）最常用于急性髓系白血病的诱导化疗。未进行预防的机构占19%，与前期调查相比逐渐上升。在发热性中性粒细胞减少症的经验性抗生素治疗中，β-内酰胺抗生素单一疗法是最常用的一线疗法。 42.2%的机构没有考虑降级。总之，这项研究阐明了 2019 年急性白血病强化化疗期间感染的现实管理，并提出了日本未来的问题。
We conducted a nationwide questionnaire-based survey in 2019 following 2001, 2007 and 2013 surveys to clarify the real-world management of infection during chemotherapy for acute leukemia in Japan. An online questionnaire was sent through SurveyMonkey(R)to member institutions of the Japan Adult Leukemia Study Group in June 2019. The questionnaire consisted of 52 multiple-choice questions covering prophylactic measures, screening and diagnostic tests, empirical antibiotic therapy, antifungal management, the usage of granulocyte-colony stimulating factor, and vaccinations against influenza and pneumococcus during intensive chemotherapy for acute leukemia. Questions associated with antimicrobial stewardship were also included. Usable responses were received from 163 of 218 (74.8%) institutions. Approximately, half (52.2%) of the institutes did not have infectious disease department. As antibiotic prophylaxis, fluoroquinolones (62%) were most commonly used in induction chemotherapy for acute myeloid leukemia. No prophylaxis accounted for 19% of the institutions, which has gradually increased compared to previous surveys. In empirical antibiotic therapy for febrile neutropenia, monotherapy with beta-lactam antibiotics was the most commonly used first-line therapy. De-escalation was not considered in 42.2% of the institutions. In conclusion, this study clarified the real-world management of infection during intensive chemotherapy for acute leukemia in 2019 and raised future issues in Japan.