Assessing the risk of false positive serum galactomannan among patients receiving piperacillin/tazobactam for febrile neutropenia

Demiraslan H., Atalay M. A., Eren E., Demir K., Kaynar L., Koç A., ...More

MEDICAL MYCOLOGY, vol.55, no.5, pp.535-540, 2017 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 55 Issue: 5
  • Publication Date: 2017
  • Doi Number: 10.1093/mmy/myw129
  • Journal Name: MEDICAL MYCOLOGY
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.535-540
  • Keywords: piperacillin/tazobactam, galactomannan test, false positivity, generic formulations, febrile neutropenia
  • Istanbul Medipol University Affiliated: No


Galactomannan (GM) assay is commonly used as an early diagnostic tool for invasive fungal infection (IFI) in high-risk hematology patients. False positivity is frequently observed in GM with the use of piperacillin/tazobactam. The usage of generic drugs over the original brand has a significant cost advantage. The aim of this study was to assess the performance of GM test among patients receiving original and generic piperacillin/tazobactam formulations. The study included 85 adult patients; 62.4% were male with hematological malignancy currently receiving piperacillin/tazobactam. The study group was divided into two groups: patients receiving original and generic piperacillin/tazobactam. Serum GM index was positive in one of 35 patients receiving original piperacillin/tazobactam, whereas it was positive in 46 out of 50 patients receiving generic piperacillin/tazobactam (P < .001). However, the patients receiving generic piperacillin/tazobactam underwent computed tomography (CT) scans more frequently than those receiving original piperacillin/tazobactam (P = .047). In addition, in vitro analysis of GMwas performed in two generics and one original piperacillin/tazobactam vials. One generic piperacillin/tazobactam vial included high GMlevel. False positivity of serum GMwith generic formulations of piperacillin/tazobactam is still an ongoing issue in hematology patients. A high rate of serum GM index false positivity may unexpectedly lead to a higher rate of CT scan. Selected piperacillin/tazobactam vials in each batch should be checked for GM to identify a false positivity of GM before purchase.