Current Antimicrobial Usage for the Management of Infections in Leukemic Patients in Japan: Results of a Survey

Yoshida, Minoru; Ohno, Ryuzo
July 2004
Clinical Infectious Diseases;7/15/2004 Supplement 1, Vol. 39, pS11
Academic Journal
We report the findings of a questionnaire distributed by the Committee of Supportive Care of the Japan Adult Leukemia Study Group to 196 hospitals throughout Japan. For antimicrobial prophylaxis, the oral quinolones are prescribed by 38% of physicians and polymixin B by 38%. For antifungal prophylaxis, amphotericin B is prescribed by 42% of physicians and Buconazole by 41%. Febrile neutropenia is empirically treated with cephalosporin or carbapenem monotherapy by 35% of physicians. Overall, dual therapy (i.e., an aminoglycoside plus a cephalusporin, a carbapenem, or an antipseudomonal penicillin) is prescribed by 50% of physicians. When response to initial empirical therapy does nut occur after 3-4 days, 51% of physicians add an antifungal agent; Buconazole is preferred to amphotericin B (prescribed by 66% vs. 28% of physicians). Foe the treatment of fungemia due to Candida albicans, fluconazole was prescribed by 59% of physicians in cases of stable disease and amphotericin B was prescribed by 57% of physicians in cases of unstable disease. Amphotericin B is selected to treat invasive aspergillosis, but a dose of 0.5-0.7 mg/kg, inadequate for this disease, is prescribed by 44% of physicians. Granulocyte colony-stimulating factor is prescribed to treat patients with acute myelogenous leukemia who have life-threatening infections (27% of physicians) or who have clinically or micro-biologically documented infections (26% of physicians).


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