University of Arkansas for Medical Sciences
Academic medical center in Little Rock, ARConnect with this customer
Febrile Neutropenia Patient
74-year-old male admitted at 12:27 for chemotherapy for multiple myeloma. Hospital course included chemotherapy, prophylaxis of acyclovir/levofloxacin/fluconazole. Patient neutropenic. 10 days after admission, Tmax measured at 38.4°C @20:33, WBC 002 (ANC0), HR 100s. Blood and urine cultures obtained.
|Empiric therapy||Vancomycin and meropenem started the next morning|
|ID/AST method||Accelerate PhenoTest® BC kit|
|ID result||Pseudomonas aeruginosa|
|AST results||Amikacin (R), cefepime (R), ceftazidime (R), ciprofloxacin (R), gentamicin (I), meropenem (I), pip-tazo (R), tobramycin (S)|
|Therapy change||Meropenem escalated to ceftolozane-tazobactam|
|Time to AST results||∼7.4h post +BC with Accelerate PhenoTest BC kit|
Time from positive BC to optimal therapy was 9.7 hours. Due to the MDR report manual testing was able to be added quickly. Ceftolozane-tazobactam susceptibility confirmed 53 hours after positive BC. LOS was long (27 days) due to other conditions. Febrile neutropenic patient on appropriately escalated therapy 24 hours after fever.
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