Universität zu Köln

Farowski, F., Bueker, V., Vehreschild, J. J., Biehl, L., Cruz-Aguilar, R., Scheid, C., Holtick, U., Jazmati, N., Wisplinghoff, H., Cornely, O. A. and Vehreschild, M. J. G. T. (2018). Impact of choice, timing, sequence and combination of broad-spectrum antibiotics on the outcome of allogeneic haematopoietic stem cell transplantation. Bone Marrow Transplant., 53 (1). S. 52 - 58. LONDON: NATURE PUBLISHING GROUP. ISSN 1476-5365

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Abstract

Recent data link the incidence of intestinal GvHD (iGvHD) after allogeneic haematopoietic stem cell transplantation (aSCT) to exposure with piperacillin-tazobactam or imipenem-cilastatin. To assess relevance of timing, duration, sequence and combination of antibiotic treatment in this setting, we applied a time-dependent model to our aSCT cohort. Patients from the prospective Cologne Cohort of Neutropenic Patients (CoCoNut) undergoing aSCT from January 2007 to April 2013 were included into a time-dependent multivariate Cox proportional hazards regression model with backward-stepwise selection. In 399 eligible patients, cumulative antibiotic exposure (hazard ratio (HR) 2.46; 95% confidence interval (95% CI) 1.59-3.81; P < 0.001) and exposure to sequential treatment with penicillin derivatives and carbapenems (HR 6.22, 95% CI 1.27-30.31), but not to the individual classes, were associated with iGvHD at day 100. Glycopeptides were assessed as a risk factor (HR 3.73, 95% CI 1.51-9.19), but not considered independent, since their use was dependent on previous exposure to penicillin derivatives and carbapenems. Patients with iGvHD presented with increased non-relapse mortality at day 365 (HR 3.51; 95% CI 2.10-5.89; P < 0.001). We identified sequential exposure to penicillin derivatives and carbapenems as well as overall exposure to antibiotics as independent risk factors for iGVHD. Confirmation of these findings in larger, prospective cohorts is necessary.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Farowski, F. UNSPECIFIED UNSPECIFIED UNSPECIFIED Bueker, V. UNSPECIFIED UNSPECIFIED UNSPECIFIED Vehreschild, J. J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Biehl, L. UNSPECIFIED UNSPECIFIED UNSPECIFIED Cruz-Aguilar, R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Scheid, C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Holtick, U. UNSPECIFIED UNSPECIFIED UNSPECIFIED Jazmati, N. UNSPECIFIED UNSPECIFIED UNSPECIFIED Wisplinghoff, H. UNSPECIFIED UNSPECIFIED UNSPECIFIED Cornely, O. A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Vehreschild, M. J. G. T. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-204170
DOI:	10.1038/bmt.2017.203
Journal or Publication Title:	Bone Marrow Transplant.
Volume:	53
Number:	1
Page Range:	S. 52 - 58
Date:	2018
Publisher:	NATURE PUBLISHING GROUP
Place of Publication:	LONDON
ISSN:	1476-5365
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language VERSUS-HOST-DISEASE; MICROBIOME; GUIDELINES; INFECTIONS; RESISTANCE; DIVERSITY; THERAPY Multiple languages Biophysics; Oncology; Hematology; Immunology; Transplantation Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/20417