Evaluation of ticarcillin/clavulanic acid versus ceftriaxone plus amikacin for fever and neutropenia in pediatric patients with leukemia and lymphoma
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
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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