Generic piperacillin/tazobactam is not associated with galactomannan false-positivity in adult patients with cancer: a case–control study

Abstract

Recent products of piperacillin/tazobactam (PTZ) from the original manufacturer, previously considered a major cause of galactomannan (GM) false-positivity, are reported not to be related to it. However, data regarding generic PTZ are limited and controversial. To evaluate the effect of generic PTZ on GM false-positivity in Korea, we performed a case-control study in adult patients with cancer. A case-control study was designed. Electronic medical records of cancer patients who were admitted and tested for serum GM between March and June 2014 at a tertiary care university hospital were reviewed. During the study period, a single generic PTZ (C manufacturer, Korea) was used. Patients who received PTZ within 24 h prior to serum GM testing were enrolled. Age- and GM test date-matched non-PTZ patients were selected as controls. A total of 110 patients received PTZ within 24 h prior to serum GM testing during the study period. The GM optical density index (ODI) of the PTZ group did not vary significantly from that of the control group (p = 0.251). The percentage of false-positive patients in the PTZ group was also similar to that of the control group (p = 0.538). There was no statistical relationship between GM ODI titer and time interval from PTZ administration (p = 0.095) or cumulative PTZ dose (p = 0.416). In a case-control study that evaluated 220 patients, a generic PTZ in Korea was not related to GM false-positivity.

Serum galactomannan antigen as a prognostic and diagnostic marker for invasive aspergillosis in heterogeneous medicine ICU patient population

“…The false positivity with piperacillin/tazobactam in GM assay for IA detection has been explored extensively, for a long period the drug combination was thought to be responsible for false positives [ 25 , 27 , 28 ]. However, in this study, GM positivity was independent of piperacillin/tazobactam therapy ( p = 0.105) similar to recently published data [ 29 – 33 ].…”

False‐positive Candida and Aspergillus antigen testing in recipients of allogeneic haematopoietic cell transplantation due to administration of parenteral nutrition and fixed combinations of piperacillin‐tazobactam

“…False‐positive GM antigenemia is reported in haematological patients after allogeneic PBSCT due to gastrointestinal chronic GvHD . However, recent publications regarding GM in beta‐lactam antibiotics and sodium gluconate could not detect GM anymore . Furthermore, false‐positive GM EIA results due to TZP or PN infusion did not occur in our investigation which is consistent with the results of our previous in vitro study .…”

“…26 However, recent publications regarding GM in beta-lactam antibiotics and sodium gluconate could not detect GM anymore. [13][14][15][16][17][18]27,28 Furthermore, false-positive GM EIA results due to TZP or PN infusion did not occur in our investigation which is consistent with the results of our previous in vitro study. 7 In contrast, Recommendations to the handling of false positivity exist only for the GM EIA.…”

“…Carried antigens originated from the manufacturing process could be detected in the final product. Recent publications have demonstrated that GM false positivity is no longer a problem in commonly used TZP preparations . However, little is known about the kinetics of mannan in serum derived from preparations for intravenous application.…”

“…Recent publications have demonstrated that GM false positivity is no longer a problem in commonly used TZP preparations. [13][14][15][16][17][18] However, little is known about the kinetics of mannan in serum derived from preparations for intravenous application. The aim of this study was to investigate the clinical relevance of the positive test results of the above-mentioned in vitro study.…”