RESUMEN
An expert group from the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC, for its acronym in Spanish) and the Spanish Society of Medical Oncology (SEOM, for its acronym in Spanish) have reviewed the main aspects to be considered when evaluating patients with solid cancer and infectious complications contained in this article. Recommendations have, therefore, been put forth regarding the prophylaxis of the most prevalent infections in these patients, the use of vaccines, measures to control infection through vascular catheters, and preventing infection in light of certain surgical maneuvers. The following is a revision of the criteria for febrile neutropenia management and the use of colonystimulating factors and closes with several guidelines for treating the cancer patient with serious infection. The document concludes with a series of measures to control hospital infection (AU)
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Asunto(s)
Humanos , Masculino , Femenino , Neutropenia Febril/complicaciones , Neutropenia Febril/tratamiento farmacológico , Criterios de Evaluación de Respuesta en Tumores Sólidos , Factores de Riesgo , Hepatitis B/complicaciones , Hepatitis B/tratamiento farmacológico , Hepatitis B/inmunología , Factor Estimulante de Colonias de Granulocitos , Factor Estimulante de Colonias de Granulocitos/inmunología , Control de Infecciones/métodos , Vacunación/tendencias , Profilaxis Antibiótica/instrumentación , Profilaxis Antibiótica/métodos , Profilaxis Antibiótica , Pneumocystis carinii , Pneumocystis carinii/aislamiento & purificaciónAsunto(s)
Humanos , Femenino , Persona de Mediana Edad , Trasplante de Riñón/efectos adversos , Trasplante de Riñón/métodos , Fiebre/complicaciones , Fiebre/etiología , Factores de Riesgo , Virosis/complicaciones , Radiografía Torácica , Infecciones/complicaciones , Técnicas Microbiológicas/métodos , Trasplante de Riñón , Hipertensión/complicaciones , Radiografía Torácica/tendencias , Creatinina/análisis , /métodos , Técnicas MicrobiológicasRESUMEN
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Asunto(s)
Femenino , Persona de Mediana Edad , Humanos , Leucemia Mieloide/microbiología , Infecciones Oportunistas/diagnóstico , Infecciones Oportunistas/terapia , Micosis/tratamiento farmacológico , Micosis/diagnóstico , Huésped Inmunocomprometido , Enfermedad AgudaRESUMEN
This study assessed the risk of haematological, renal and hepatic toxicity associated with amphotericin B lipid complex (ABLC; Abelcet) in a multicentre, open-label, non-comparative study of 93 patients from 17 different hospitals who received ABLC because of proven or suspected systemic fungal infection or leishmaniasis. Most (66%) patients had onco-haematological diseases. Optimum treatment with ABLC comprised a slow (2-h) infusion dose of 5 mg/kg/day for a minimum period of 14 days. Biochemical and haematological parameters were measured pre-, during and post-treatment. In the overall patient group, the mean serum creatinine concentration was similar pre- and post-study (1.00 +/- 1.14 mg/dL vs. 1.20 +/- 1.19 mg/dL; p > 0.05). There were no significant changes pre- and post-treatment in concentrations of haemoglobin, potassium, transaminases and bilirubin. There was no significant correlation between the dose administered and the concentrations of serum creatinine (Spearmann 0.22). There was no greater nephrotoxicity in the patients with previous renal failure, or in those who had received amphotericin B previously. There were serious adverse events in five patients, but other alternative causes that could explain these events were present in three of these patients. Fevers or chills were experienced by 23% of the patients during the ABLC infusion, but only in one case did this necessitate the suspension of treatment. It was concluded that ABLC is a drug with low nephrotoxicity, even when administered to patients with pre-existing renal insufficiency. Adverse events were generally slight or moderate, and were managed easily with appropriate pre-medication.