Related Experiment Video
Updated: May 30, 2026
Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
Published on: August 30, 2018
[Use of the critical path with the electronic chart system using meropenem, vancomycin, liposome amphotericin B for
Tsunehiko Komatsu1, Yuko Kimura, Mika Sudo
1Department of Hematology, Teikyo University Chiba Medical Center.
Abstract:
Febrile neutropenia (FN) is a serious complication associated with morbidity and mortality. To manage infections in neutropenic patients, it is necessary to administer empirical antibiotic therapy in a timely and efficient manner. We developed an electronic critical pathway system for a computer-stored medical record system (EGMAIN-GX, Fujitsu), which matches FN patients to either: i) the first-line therapy with meropenem (3 g/day) alone, or ii) the second-line therapy with meropenem plus vancomycin (2 g/day). If patients do not respond to the first-line therapy within 72 hours, then they are provided with the second-line therapy. A total of 28 FN events were treated in 14 patients presenting with hematological malignancies. The mean and median neutrophil counts were 42 (0-300)/microl and 0/microl, respectively. The response rates with the first-line and second-line therapies were 57% and 93%, respectively. There were no serious adverse events. Meropenem is a highly effective treatment for FN. Use of an electronic critical pathway system could ensure that neutropenic patients receive this necessary empiric therapy in a timely manner so as to prevent the serious complications associated with FN.
Insights
Febrile neutropenia (FN) management improved with an electronic critical pathway. This system ensures timely meropenem-based antibiotic therapy, enhancing patient outcomes and preventing severe complications.
Area of Science:
- Oncology
- Infectious Diseases
- Health Informatics
Background:
- Febrile neutropenia (FN) is a critical complication in cancer patients, increasing morbidity and mortality.
- Timely and efficient empirical antibiotic therapy is crucial for managing infections in neutropenic individuals.
Purpose of the Study:
- To evaluate an electronic critical pathway system for optimizing febrile neutropenia treatment.
- To assess the efficacy and safety of meropenem-based empirical antibiotic strategies.
Main Methods:
- Development of an electronic critical pathway integrated with a computer-stored medical record system (EGMAIN-GX).
- Patients were stratified into first-line (meropenem) and second-line (meropenem plus vancomycin) therapy based on response within 72 hours.
- Retrospective analysis of 28 FN events in 14 hematological malignancy patients.
Main Results:
- First-line therapy with meropenem achieved a 57% response rate.
- Second-line therapy, initiated for non-responders, yielded a 93% response rate.
- No serious adverse events were reported during the study period.
Conclusions:
- Meropenem demonstrates high efficacy in treating febrile neutropenia.
- The electronic critical pathway system facilitates timely empirical antibiotic administration, potentially preventing severe FN complications.
Related Concept Videos
01:15Determination of Multiple Dosing Parameters: Steady-State, Minimum and Maximum Concentrations
01:18Endocarditis III: Medical Management