Patient selection: hematology patient with febrile neutropenia
Risk factors for shock:
(1) bacteremia due to E. coli, Enterobacter species or Acinetobacter species (odds ratios 8.5, 7.5 and 7.0 respectively)
Factors associated with increased risk of early death:
(1) non-Hodgkin's lymphoma (odds ratio 3.6)
(2) pneumonia (odds ratio 21.4)
(3) shock (odds ratio 11.6)
(4) bacteremia due to Klebsiella pneumoniae (odds ratio 5.9)
A positive blood culture with Pseudomonas aeruginosa was also associated with early death.
Factor associated with reduced risk for early death
(1) adequate therapy with empirical antibiotic therapy
Shock or early death were not associated with Gram-positive bacteremia or inadequate Gram-positive coverage. This raised questions about the need to give vancomycin as empiric therapy.
