The Development of a Decision-Making System for Extended Treatment in Patients with Hematologic Malignancy with Acinetobacter baumannii Bloodstream Infections Following 14-day Antibiotic Treatment.

  • Natharin Phattayanon Faculty of Pharmacy, Payap University.
Keywords: Hematologic malignancy, Acinetobacter baumannii, Mortality prediction model, Decision-making system, Extended antibiotic therapy.

Abstract

     Patients with hematologic malignancy (HM) and afflicted with Acinetobacter baumannii (AB) bloodstream infections encounter considerable mortality risks, despite conventional antibiotic treatment being continued for 14 days. Assuring which patients would benefit from prolonged antibiotic therapy to decrease mortality continues to be a difficult clinical challenge. In order to identify HM patients with AB systemic infections who would benefit from extended antibiotic therapy beyond 14 days, this research attempts to establish a decision-making system by developing a clinical predictive tool. A retrospective cohort research was conducted on patients with hematologic malignancies (HM) who developed bloodstream infections and were treated with a 14-day course of antibiotics within the specified period from January 2011to April 2023. Data on clinical and demographic factors have been collected, including age, gender, comorbidities, laboratory testing, antibiotic regimen, and outcomes.

     The predictive model and the “Ex-CSEPA” decision-making system were developed using logistic regression. The performance metrics, including sensitivity, specificity, positive predictive value, negative predictive value, and area under the receiver operating characteristic curve (AUC-ROC), were evaluated. The developed model demonstrated exceptional performance, achieving an accuracy of 98.7%. It exhibited a sensitivity of 99.07% and a specificity of 98.33% in predicting mortality, setting a cutoff point of 0.5 or higher as indicative of high risk for mortality after 14-day treatment. The system's ability to identify patients who would benefit from antibiotic (ATB) treatment beyond the standard 14-day period was particularly significant. The application of this predictive model in clinical practice has pushed up the potential to enhance decisions for extended-ATB duration and decrease 30-day mortality for patients with HM who are morbid with AB bloodstream infections.

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Published
2024-11-28
How to Cite
Phattayanon, N. (2024). The Development of a Decision-Making System for Extended Treatment in Patients with Hematologic Malignancy with Acinetobacter baumannii Bloodstream Infections Following 14-day Antibiotic Treatment. Indonesian Journal of Pharmacy. https://doi.org/10.22146/ijp.12924
Section
Research Article