[Empirical antimicrobial therapy of infection and fever episodes in children and adolescents with neutropenia caused by cytotoxic chemotherapy].
The experience with empirical antimicrobial therapy of septicemia and febrile episodes in pediatric neutropenic patients was analyzed retrospectively. Between January 1985 and March 1988 in 49 patients 77 episodes were observed. Bacteremia was found in 15 (20%), culture proven localized bacterial infection in 11 (14%) and clinically diagnosed bacterial infection was found in 7 (9%) of the febrile episodes. Thus, 33 (43%) documented bacterial infections were observed. For initial therapy a combination of aminoglycoside plus 2nd/3rd generation cephalosporin (60%) or aminoglycoside plus piperacillin (30%) was usually chosen. Both regimens were equally effective. 52% and 56%, respectively, were sufficiently treated with the initial regimen. 95% of all episodes resolved completely, the mortality rate was 5%. Central venous catheters remained in situ in 84% of the cases. The period of time necessary for recovery of granulopoiesis had an influence on the therapy success.
Fink
F M
FM
Universitäts-Kinderklinik, Innsbruck.
Frischhut-Schiffer
E M
EM
Ausserer
B
B
Allerberger
F
F
Guggenbichler
J P
JP
D000293:Adolescent; D000380:Agranulocytosis / Q000139:chemically induced*; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D002435:Cefamandole / Q000627:therapeutic use; D002439:Cefotaxime / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D004359:Drug Therapy, Combination / Q000627:therapeutic use*; D005260:Female; D005335:Fever of Unknown Origin / Q000188:drug therapy*; D005839:Gentamicins / Q000627:therapeutic use; D006801:Humans; D007223:Infant; D007260:Infusion Pumps; D007958:Leukocyte Count / Q000187:drug effects; D008297:Male; D009369:Neoplasms / Q000188:drug therapy*; D009503:Neutropenia / Q000139:chemically induced* / Q000150:complications; D010878:Piperacillin / Q000627:therapeutic use; D018805:Sepsis / Q000188:drug therapy*
D000970:Antineoplastic Agents; D005839:Gentamicins; D002435:Cefamandole; D002439:Cefotaxime; D010878:Piperacillin
Empirische antimikrobielle Therapie von Sepsis- und Fieberepisoden bei Kindern und Jugendlichen mit Neutropenie infolge zytotoxischer Chemotherapie.