title: Management of septicemia and early death in acute leukemia.
abstract: The frequency of fever days was measured in 67 patients with acute leukemia in the initial phase until remission was obtained or the patient died. A total of 3411 hospital days were studied. Three antibiotic schedules were examined between 1970 and 1975. There were 50% fever days when penicillin and streptomycin were combined as initial antibiotics, 37% when cephalosporin and gentamycin were used, and 31% when, in addition, semi-isolation was used prophylactically and granulocytes were given in a therapeutic attempt (0.05 greater than p greater than 0.01). The corresponding frequencies of early death were 9/21 (43%), 6/23 (26%) and 5/23 (22%). Early death occurred on an average 14, 23 and 21 days after admission. The frequencies of remission (complete and partial) were 8/21 (38%), 12/23 (52%), and 13/23 (57%). A randomized subgroup (12 patients) with intestinal sterilization was studied separately. It had 28% fever days, which is significantly less (p less than 0.01) than in the 13 patients given the same systemic antibiotics without intestinal sterilization. Fever was significantly lower (0.05 greater than p greater than 0.01) on the day after a series of granulocyte transfusions than before, although only 10(9) granulocytes were given. However, this fever reduction may have been due to concomitant antibiotics.
mesh_terms: D000208:Acute Disease; D001803:Blood Transfusion; D002511:Cephalosporins / Q000627:therapeutic use; D005260:Female; D006098:Granulocytes; D006801:Humans; D007422:Intestines / Q000382:microbiology; D007938:Leukemia / Q000150:complications*; D007958:Leukocyte Count; D008297:Male; D010356:Patient Isolation; D010406:Penicillins / Q000627:therapeutic use; D012075:Remission, Spontaneous; D018805:Sepsis / Q000188:drug therapy* / Q000209:etiology / Q000517:prevention & control; D013307:Streptomycin / Q000627:therapeutic use
chemical_list: D002511:Cephalosporins; D010406:Penicillins; D013307:Streptomycin