Albasanz-Puig, AdaiaDurà-Miralles, XavierLaporte-Amargós, JúliaMussetti, AlbertoRuiz-Camps, IsabelPuerta-Alcalde, PedroAbdala, EdsonOltolini, ChiaraAkova, MuratMontejo ,José MiguelMalgorzata, MikulskaMartín-Dávila, PilarHerrera, FabiánGasch, OriolDrgona, LubosPaz Morales, Hugo ManuelBrunel, Anne-SophieGarcía, EstefaníaIsler, BurcuKern, Winfried V.Retamar-Gentil, PilarAguado, José MaríaMontero, MilagrosKanj, Souha S.Sipahi, Oguz R.Calik, SebnemMárquez-Gómez, IgnacioMarín, Jorge I.Gomes, Marisa Z.R.Hemmati, PhilippAraos Bralic, Rafael IgnacioPeghin, MagdalenaPozo, José Luis delYáñez, LucreciaTilley, RobertManzur, AdrianaNovo, AndresPallarès, NatàliaBergas, AlbaCarratalà, JordiGudiol, CarlotaThe Ironic Study Group2023-12-052023-12-052022Albasanz-Puig, A.; Durà-Miralles, X.; Laporte-Amargós, J.; Mussetti, A.; Ruiz-Camps, I.; Puerta-Alcalde, P.; Abdala, E.; Oltolini, C.; Akova, M.; Montejo, J.M.; et al. Effect of Combination Antibiotic Empirical Therapy on Mortality in Neutropenic Cancer Patients with Pseudomonas aeruginosa Pneumonia. Microorganisms 2022, 10, 733. https://doi.org/10.3390/ microorganisms10040733https://repositorio.udd.cl/handle/11447/8139To assess the effect of combination antibiotic empirical therapy on 30-day case-fatality rate in neutropenic cancer patients with Pseudomonas aeruginosa (PA) bacteremic pneumonia. This was a multinational, retrospective cohort study of neutropenic onco-hematological patients with PA bloodstream infection (BSI) (2006−2018). The effect of appropriate empirical combination therapy, appropriate monotherapy and inappropriate empirical antibiotic therapy [IEAT] on 30-day case-fatality was assessed only in patients with PA bacteremic pneumonia. Among 1017 PA BSI episodes, pneumonia was the source of BSI in 294 (28.9%). Among those, 52 (17.7%) were caused by a multidrug-resistant (MDR) strain and 68 (23.1%) received IEAT, mainly when the infection was caused by an MDR strain [38/52 (73.1%) vs. 30/242 (12.4%); p < 0.001]. The 30-day case-fatality rate was higher in patients with PA bacteremic pneumonia than in those with PA BSI from other sources (55.1% vs. 31.4%; p < 0.001). IEAT was associated with increased 30-day case-fatality (aHR 1.44 [95%CI 1.01−2.03]; p = 0.042), whereas the use of appropriate combination empirical treatment was independently associated with improved survival (aHR 0.46 [95%CI 0.27−0.78]; p = 0.004). Appropriate empirical monotherapy was not associated with improved overall survival (aHR 1.25 [95%CI 0.76−2.05]; p = 0.39). Combination antibiotic empirical therapy should be administered promptly in febrile neutropenic patients with suspected pneumonia as the source of infection.14 p.enPseudomonas aeruginosaBloodstream infectionPneumoniaSeptic shockNeutropeniaArticlehttps://doi.org/10.3390/ microorganisms10040733