Pseudomonas bacteremia. Retrospective analysis of 410 episodes

Abstract

Episodes (410) of Pseudomonas bacteremia occurring in patients with cancer were studied during a 10-yr period. Pseudomonas bacteremia was most common among patients with acute leukemia. The majority of patients acquired their infections in the hospital, and 51% had received antibiotic therapy for other presumed or proved infection during the preceding week. Shock occurred in 33%, and 32% had concomitant pneumonia. The overall cure rate was 62%; it was 67% for patients receiving appropriate antibiotics but only 14% for those receiving inappropriate antibiotics. A 1-2-day delay in the administration of appropriate antibiotic therapy reduced the cure rate from 74%-46%. Patients who received an antipseudomonal .beta.-lactam antibiotic with or without an aminoglycoside had a significantly higher cure rate than patients who received only an aminoglycoside (72% and 71% vs. 29%). Patients with shock, pneumonia, or persistent neutropenia had a substantially poorer prognosis.