Multiday corticosteroids in cancer chemotherapy delay the diagnosis of and antimicrobial administration for febrile neutropenia: a double-center retrospective study

Table 4 Univarate and multivariate analyses of risk factors for delaying antimicrobial administration

Variable	Univariate analysis		P	Multivariate analysis
	No. of patients (%)^a			OR (95% CI)	P ^e
	fast^b	late^b
	(n = 107)	(n = 106)
Age (year)
< 65	61(57)	58(55)	0.78^c
Sex
Male	58(54)	49(46)	0.27^c	0.71(0.50–1.20)	0.16
ECOG PS
0	41(38)	40(38)	0.77^d
1	48(45)	53(50)
2	13(12)	10(9.4)
3	5(4.7)	3(2.8)
CCr (mL/min)^f
< 50	9(8.4)	12(11)	0.50^c
T-Bil (mg/dL)
< 2	5(4.7)	7(6.6)	0.57^c
FN rate of regimen^g
Low (< 10%)	64(60)	65(61)	0.48^d
Moderate (10 to < 20%)	31(29)	34(32)
High (≥20%)	12(11)	7(6.6)
Stage
II	18(17)	15(14)	0.79^d
III	41(38)	39(37)
IV	48(45)	52(49)
Duration of corticosteroid use
Multiday^h	11(10)	30(28)	0.001^c	3.94(1.80–8.62)	< 0.001
CYP3A4 inhibitor
Use	11(10)	17(16)	0.23^c	2.04(0.86–4.84)	0.11
MASCC score
High risk (≤20)	52(49)	41(39)	0.17^c	1.38(0.78–2.46)	0.27
Blood culture
Positive	10(9.3)	9(8.5)	1.0^c

^a The sum of the percentages may not equal 100% because of rounding off
^b The classification into “fast” and “late” groups was based on the median TABE, 1.20 days
^c Fisher’s exact test
^d chi-squared test
^e Logistic regression analysis
^f The values were calculated using the Cockcroft-Gault formula
^g Each rate was based on previous clinical studies [2,3,4,5,6]
^h The multiday group included patients who were administered corticosteroid every day from the initiation of chemotherapy to onset of FN irrespective of its dosage
OR odds ratio, CI confidence interval, ECOG PS Eastern Cooperative Oncology Group performance status, CCr creatinine clearance, T-Bil total bilirubin, FN febrile neutropenia, CYP cytochrome P450, MASCC Multinational Association for Supportive Care in Cancer
TABE: the time to antimicrobial administration from the time when body temperature exceeded the baseline temperature

ISSN: 2055-0294