Verlinden, Anke

Abstract: Patients suffering from haematological malignancies have both quantitative and qualitative deficits in immune cells, making them susceptible to life-threatening bacterial, viral and fungal infections. Chemotherapy increases this risk by disrupting protective mucosal barriers and causing prolonged periods of severe neutropenia. Common strategies for the prevention and treatment of febrile neutropenia include long-term use of broad-spectrum antibiotics. However, long-term treatment with broad-spectrum antibiotics has been associated with the development and selection of multidrug resistant bacteria. Rising antimicrobial resistance rates worldwide have been confirmed in hematology patients and recipients of hematopoietic stem cell transplants. The articles presented in this thesis describe our practical experience in implementing policy changes aimed at reducing the consumption of broad-spectrum antibiotics in the hematology department of the Antwerp University Hospital. We addressed both the prophylactic and treatment settings through a step-by-step approach with a focus on patient safety. We analyzed the clinical and microbiological impact of each change in our standard operating procedures

Antimicrobial stewardship in neutropenic haematological patients

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