Treatment of gram-positive septicemia in cancer patients.
Seventy-eight pediatric cancer patients were treated for gram-positive bacterial septicemia during a 10-year period (1968-1977). Sixty-one (78%) of the patients were granulocytopenic (PMNs less than 500/mm3) at the onset of the septic episode. All the patients whose granulocytopenia resolved (PMNs greater than 500/mm3) within one week of therapy recovered without sequelae. However, 7 of 15 patients (47%) who remained granulocytopenic for more than 7 days and who were treated with a single antibiotic developed a second sepsis with a gram-negative organism. In contrast, second infections were not observed in 24 patients with PMNs less than 500/mm3 for more than 7 days who were treated with broad spectrum antibiotics (p less than 0.002), suggesting that a broad-spectrum antibiotic regimen may be preferable when a cancer patient has prolonged granulocytopenia.
D000380:Agranulocytosis / Q000150:complications; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D002648:Child; D004359:Drug Therapy, Combination; D006801:Humans; D009369:Neoplasms / Q000150:complications*; D018805:Sepsis / Q000150:complications / Q000188:drug therapy*; D013203:Staphylococcal Infections / Q000150:complications / Q000188:drug therapy*; D013290:Streptococcal Infections / Q000150:complications / Q000188:drug therapy*
D000900:Anti-Bacterial Agents