The impact of infectious diseases consultation on oncology practice

Granwehr, Bruno; Kontoyiannis, Dimitrios P.

doi:10.1097/cco.0b013e3283622c32

Cited by 18 publications

(9 citation statements)

References 37 publications

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“…In the other, most of the isolates were susceptible to fluconazole [10]. In cancer patients with candidaemia, ID consultation can contribute to optimization of care through not only prompt initiation of appropriate antifungals and source control, but also management of other concomitant infections, medication toxicity and antifungal stewardship [27]. The latter is of particular importance in the cancer patient population, because our rates of in vitro caspofungin and MDR were among the highest reported to date.…”

Section: CMImentioning

confidence: 97%

Early initiation of appropriate treatment is associated with increased survival in cancer patients with Candida glabrata fungaemia: a potential benefit from infectious disease consultation

Farmakiotis

Kyvernitakis

Tarrand

et al. 2015

Clinical Microbiology and Infection

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In patients with malignancies, Candida glabrata is one of the most frequent non-albicans Candida clinical isolates. As antifungal resistance in C. glabrata is common, we investigated the relationship between early appropriate antifungal treatment, infectious disease (ID) consultation and mortality in a contemporary cohort of cancer patients with C. glabrata fungaemia. We included patients with at least one C. glabrata-positive blood culture and symptoms or signs of infection seen at the MD Anderson Cancer Center between March 2005 and September 2013. In vitro susceptibility to antifungals was defined according to the 2010 CLSI clinical breakpoints. One-hundred and forty-six episodes of candidaemia were studied. Thirty isolates (20.5%) had fluconazole MIC ≥ 64 mg/L and 15 (10.3%) were caspofungin-resistant. Early (within 48 h after blood culture collection) initiation of appropriate antifungal treatment (hazard ratio 0.374, p 0.003) and early ID consultation (hazard ratio 0.421, p 0.004) were associated with decreased mortality, after adjustment for significant confounders. Thirty-two of 58 patients (55.2%) followed by ID were on appropriate antifungals within 48 h, compared with 16/88 patients (18.2%) who were not followed by ID an ID specialist (p <0.001). The median time-to-reporting of blood culture positivity for yeast was 71 h. Delayed time-to-reporting was associated with increased 28-day all-cause mortality (log-rank p 0.023). The benefits from early initiation of appropriate antifungal treatment and ID consultation were more prominent in patients with non-catheter-related candidaemia. In conclusion, in cancer patients with C. glabrata fungaemia, early ID consultation may lead to timely initiation of appropriate treatment and improved clinical outcomes.

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Section: CMImentioning

confidence: 97%

Early initiation of appropriate treatment is associated with increased survival in cancer patients with Candida glabrata fungaemia: a potential benefit from infectious disease consultation

Farmakiotis

Kyvernitakis

Tarrand

et al. 2015

Clinical Microbiology and Infection

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“…A major limitation of the existing studies is that they are almost exclusively conducted by ID specialists, who clearly have an interest in demonstrating their own usefulness and this may impact the credibility of these findings for other physicians. Recent studies have examined the involvement of ID consultants in some inpatient specialty areas, including orthopaedic surgery, critical care and oncology [60][61][62][63]. These studies suggest, not surprisingly, that involvement of ID consultants often results in modification of the antibiotic treatment regimen and may also decrease overall antibiotic use, costs and complications [60].…”

Section: Value Of the Infectious Diseases Consultantmentioning

confidence: 99%

Special considerations of antibiotic prescription in the geriatric population

Beckett

Harbarth²,

Huttner³

2015

Clinical Microbiology and Infection

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Infectious diseases pose a major challenge in the elderly for two reasons: on the one hand the susceptibility to infection increases with age and when infections occur they often present atypically-on the other hand diagnostic uncertainty is much more pronounced in the geriatric population. Reconciling the opposing aspects of optimizing patient outcomes while avoiding antibiotic overuse requires significant expertise that can be provided by an infectious diseases consultant. In addition, geriatric facilities are reservoirs for multidrug-resistant organisms and other nosocomial pathogens, and infectious diseases consultants also play a vital role in assuring appropriate infection control measures. In this review we outline the challenges of diagnosis and management of infectious diseases in the elderly, and discuss the importance of appropriate antibiotic use in the elderly in order to demonstrate the value of the infectious diseases consultant in this special setting.

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“…ID involvement was determined to significantly contribute to patient care in 62% of the 598 patient charts evaluated [33]. A review of ID specialty impact that included both inpatient and outpatient oncology practice data noted benefits including up to 34% increase in adherence to clinical guidelines, up to 52% increase in prescription of appropriate antimicrobial therapy duration, and up to 17% decrease in mortality [34]. The value of ID consultants in supporting transition of care after hospital discharge was also highlighted, along with their role in the prevention of recurrent and future infections.…”

Section: The Essential Role Of Infectious Disease Specialists In the mentioning

confidence: 99%

Impact of Infection on Transplant Outcomes: Transplant Infectious Disease Expertise as an Essential Component of Transplant Programs

Morris¹

2020

Emerging Transplant Infections

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Infectious complications are a major cause of morbidity and mortality in both solid organ and hematopoietic stem cell transplant patients. The risk of infection by common opportunistic pathogens like cytomegalovirus can be mitigated with the optimal use of molecular diagnostics and antiviral prophylaxis. Novel and emerging bacterial, viral, fungal, and parasitic pathogens may be more successfully managed with early diagnosis and therapy. In the care of solid organ and hematopoietic stem cell transplant candidates and recipients, involvement of physicians with expertise in transplant infectious diseases has been shown to improve outcomes. In addition to their essential role in decreasing patient morbidity and mortality, infectious disease specialists also add value to the transplant program through the development and implementation of infection prevention protocols. These specialists are on the front line of the response to new organisms that may present atypically or be difficult to recognize in patients receiving immunosuppressive therapies pre-and post-transplant. In this rapidly changing field, the Emerging Transplant Infections textbook provides updated information on the diagnosis, treatment, and prevention of significant infections often seen in this highly immunocompromised population.

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The impact of infectious diseases consultation on oncology practice

Abstract: Infectious diseases consultants contribute value in various inpatient and outpatient infections, decreasing mortality, cost, and complications.

Cited by 18 publications

References 37 publications

Early initiation of appropriate treatment is associated with increased survival in cancer patients with Candida glabrata fungaemia: a potential benefit from infectious disease consultation

Early initiation of appropriate treatment is associated with increased survival in cancer patients with Candida glabrata fungaemia: a potential benefit from infectious disease consultation

Special considerations of antibiotic prescription in the geriatric population

Impact of Infection on Transplant Outcomes: Transplant Infectious Disease Expertise as an Essential Component of Transplant Programs

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