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Evaluation of ticarcillin/clavulanic acid versus ceftriaxone plus amikacin for fever and neutropenia in pediatric patients with leukemia and lymphoma
Petrilli, Antonio Sérgio; Cypriano, Monica; Dantas, Lenice Silva; Lee, Lúcia Martino; Luisi, Maria Flávio Augusto Vercillo; Silva, Katia Veronica Torres B; Pereira, Carlos Alberto Pires.
  • Petrilli, Antonio Sérgio; Federal University of São Paulo. Division of Infectious Disease. Pediatric Oncology Institute. São Paulo. BR
  • Cypriano, Monica; Federal University of São Paulo. Division of Infectious Disease. Pediatric Oncology Institute. São Paulo. BR
  • Dantas, Lenice Silva; Federal University of São Paulo. Division of Infectious Disease. Pediatric Oncology Institute. São Paulo. BR
  • Lee, Lúcia Martino; Federal University of São Paulo. Division of Infectious Disease. Pediatric Oncology Institute. São Paulo. BR
  • Luisi, Maria Flávio Augusto Vercillo; Federal University of São Paulo. Division of Infectious Disease. Pediatric Oncology Institute. São Paulo. BR
  • Silva, Katia Veronica Torres B; Federal University of São Paulo. Division of Infectious Disease. Pediatric Oncology Institute. São Paulo. BR
  • Pereira, Carlos Alberto Pires; Federal University of São Paulo. Division of Infectious Disease. Pediatric Oncology Institute. São Paulo. BR
Braz. j. infect. dis ; 7(2): 111-120, Apr. 2003. tab
Article Dans Anglais | LILACS | ID: lil-351154
RESUMO

BACKGROUND:

The empirical use of antibiotic treatments is widely accepted as a means to treat cancer patients in chemotherapy who have fever and neutropenia. Intravenous monotherapy, with broad spectrum antibiotics, of patients with a high risk of complications is a possible alternative.

METHODS:

We conducted a prospective open-label, randomized study of patients with lymphoma or leukemia who had fever and neutropenia during chemotherapy. Patients received either monotherapy with ticarcillin/clavulanic acid (T) or ceftriaxone plus amikacin (C+A).

RESULTS:

Seventy patients who presented 136 episodes were evaluated, 68 in each arm of the study. The mean neutrophil counts at admission were 217cells/mm (T) and 201cells/mm (C+A). The mean duration of neutropenia was 8.7 days (T) and 7.6 days (C+A). Treatment was successful without the need for modifications in 71 percent of the episodes in the T group and 81 percent in the C+A group (p=0.23). Treatment was considered to have failed because of death in two episodes (3 percent) in the T group and three episodes (4 percent) in the C+A group, and because of a change in the drug applied in one episode in the T group and two episodes in the C+A group. Overall success was 96 percent (T) and 93 percent (C+A). Adverse events that occurred in group T were not related to the drugs used in this study.

CONCLUSION:

In pediatric and adolescent patients with leukemia or lymphoma, who presented with fever and neutropenia, during chemotherapy, ticarcillin/clavulanic acid was as successful as the combination of ceftriaxone plus amikacin. It should be considered an appropriate option for this group of patients at high risk for infections
Sujets)
Texte intégral: Disponible Indice: LILAS (Amériques) Sujet Principal: Ticarcilline / Lymphome malin non hodgkinien / Leucémies / Acides clavulaniques / Association de médicaments / Fièvre / Neutropénie Type d'étude: Essai clinique contrôlé / Etude d'étiologie / Étude observationnelle / Étude pronostique / Facteurs de risque Limites du sujet: Adolescent / Enfant / Enfant d'âge préscolaire / Femelle / Humains / Bébé / Mâle Pays comme sujet: Amérique du Sud / Brésil langue: Anglais Texte intégral: Braz. j. infect. dis Thème du journal: Maladies transmissibles Année: 2003 Type: Article Pays d'affiliation: Brésil Institution/Pays d'affiliation: Federal University of São Paulo/BR

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Texte intégral: Disponible Indice: LILAS (Amériques) Sujet Principal: Ticarcilline / Lymphome malin non hodgkinien / Leucémies / Acides clavulaniques / Association de médicaments / Fièvre / Neutropénie Type d'étude: Essai clinique contrôlé / Etude d'étiologie / Étude observationnelle / Étude pronostique / Facteurs de risque Limites du sujet: Adolescent / Enfant / Enfant d'âge préscolaire / Femelle / Humains / Bébé / Mâle Pays comme sujet: Amérique du Sud / Brésil langue: Anglais Texte intégral: Braz. j. infect. dis Thème du journal: Maladies transmissibles Année: 2003 Type: Article Pays d'affiliation: Brésil Institution/Pays d'affiliation: Federal University of São Paulo/BR