[Antibiotic prophylaxis and therapy of febrile aplastic children with acute leukemia].
One hundred and twenty-one febrile episodes (FE) were studied in 58 aplastic children with acute leukemia. All patients received a prophylactic regimen of trimethoprim-sulfamethoxazole (TS) and colistin sulfate orally, and amphotericin B locally from the beginning of their antineoplastic therapy. Eighty episodes were analysed retrospectively. Forty-one episodes in 24 patients were treated prospectively with a standard regimen of gentamicin + cefotaxime. The results show that the prophylactic regimen does not eradicate potentially pathogenic organisms from the throat, urine, or stools. Sixty-three per cent of FE were of unknown origin (FUU). 40.5% of all isolated organisms were TS resistant. In the prospective group, 9 of 41 FE (22%) responded to gentamicin + cefotaxime with lysis of fever within 48 hours, and 63% required no further antibiotics. Defeverescence occurred in the whole group within 5 +/- 4 days. No patients were lost to infectious complications. The combination of gentamicin + cefotaxime as initial therapy of a febrile episode must be supplemented within 48 to 72 hours by additional antibiotics in the absence of clinical improvement.
D000666:Amphotericin B / Q000627:therapeutic use*; D000741:Anemia, Aplastic / Q000150:complications; D001424:Bacterial Infections / Q000517:prevention & control*; D002177:Candidiasis / Q000517:prevention & control*; D002439:Cefotaxime / Q000627:therapeutic use; D002648:Child; D003091:Colistin / Q000627:therapeutic use*; D004338:Drug Combinations / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005334:Fever / Q000188:drug therapy; D005839:Gentamicins / Q000627:therapeutic use; D006801:Humans; D007945:Leukemia, Lymphoid / Q000150:complications*; D015470:Leukemia, Myeloid, Acute / Q000150:complications*; D013420:Sulfamethoxazole / Q000627:therapeutic use*; D014295:Trimethoprim / Q000627:therapeutic use*; D015662:Trimethoprim, Sulfamethoxazole Drug Combination
D004338:Drug Combinations; D005839:Gentamicins; D000666:Amphotericin B; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D014295:Trimethoprim; D013420:Sulfamethoxazole; D002439:Cefotaxime; D003091:Colistin
Antibiotische Prophylaxe und Therapie von febrilen aplastischen Kindern mit akuter Leukämie.