[Empirical treatment of febrile episodes in patients with neutropenia in bone marrow transplantation].
The results of therapy of febrile episodes during the pregraft phase in bone marrow transplant was retrospectively evaluated in 84 granulocytopenic patients. Most patients received co-trimoxazole and i.v. ticarcillin as antibacterial prophylaxis. 47 episodes were treated with a third generation cephalosporin plus an aminoglycoside, with a 55% favorable response rate. 37 episodes were treated with a wide spectrum penicillin plus an aminoglycoside, with a 41% response rate (p greater than 0.05). Among the 23 infections caused by gram-negative bacilli the response rate was 89% (8 of 9) with the first regimen, and 21% (3 of 14) with the second one (p = 0.003). The investigation of in vitro sensitivity suggested that prophylactic ticarcillin favors the infections due to bacilli with cross-resistance to wide spectrum penicillins. The antibiotic regimen did not influence the final resolution or the mortality rate of the febrile episode.
Pérez
M
M
Servicio de Hematología, Hospital Nacional Marqués de Valdecilla, Santander.
Muruzábal
M J
MJ
Gómez Casares
M T
MT
Alsar
M J
MJ
Conde
E
E
Iriondo
A
A
Garijo
J
J
Richard
C
C
Baro
J
J
Aguado
J M
JM
D000328:Adult; D000617:Aminoglycosides; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D016026:Bone Marrow Transplantation; D002511:Cephalosporins / Q000627:therapeutic use*; D004352:Drug Resistance, Microbial; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D005260:Female; D005334:Fever / Q000188:drug therapy* / Q000209:etiology / Q000382:microbiology; D006090:Gram-Negative Bacteria / Q000187:drug effects; D006801:Humans; D008297:Male; D009503:Neutropenia / Q000150:complications*; D011292:Premedication / Q000009:adverse effects; D012189:Retrospective Studies; D018805:Sepsis / Q000188:drug therapy* / Q000209:etiology; D013982:Ticarcillin / Q000627:therapeutic use*; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use*
D000617:Aminoglycosides; D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D013982:Ticarcillin
Estudio del tratamiento empírico de los episodios febriles en pacientes con neutropenia en el trasplante de medula ósea.