n = number of episodes of FN ANC – absolute neutrophil count APC – absolute phagocyte count (ANC + monocyte count) Two patients died during their admission for FN.
In 13/199 episodes (7%), IVAMT was discontinued when the absolute phagocyte count (APC) was < 100/mm.
The authors found that although survival appeared better in patients managed with APC, the absolute benefit (3.3%) was lower than in the PROWESS study (6.5%) and was not statistically significant [ 1, 3].
All patients at Montefiore Medical Center with severe sepsis at high risk for death and without absolute contraindications are considered eligible for APC at the discretion of the attending intensivist.
AMC – absolute monocyte count ANC – absolute neutrophil count APC – absolute phagocyte count °C – degrees Celsius FN – febrile neutropenia IVAMT – intravenous antimicrobial therapy MDI – microbiologically defined infection The author(s) declare that they have no competing interests.
The CD4-APC, CD8-PE, CD3-FITC, CD19-APC, CD16CD56-PE fluorescent antibody, hemolysin (10×) and absolute count tubes (Trucount tube) were each purchased from BD Biosciences.
Advanced liver disease (ALD) was an exclusion criteria from enrollment in the major clinical trials of recombinant human activated protein C (APC), but is listed on the package insert as a relative contraindication rather than an absolute contra-indication to APC administration [ 1].
APC and Tripp Lite make popular models.
