title: [Role of Abelcet in children with febrile neutropenia].
abstract: OBJECTIVE
  In order to optimise the use of new forms of Amphotericine B (Ampho B), a decisional tree was created at the end of 2001 in the paediatric hemato-oncology unit for the empirical antifungal treatment in febrile neutropenic children: the standard remained conventional Ampho B and Abelcet was proposed in case of antecedent or occurrence of a deterioration of the renal function (DRF). In order to validate the place of Abelcet we initiated a retrospective study over year 2002.
  
  
  RESULTS
  21 treatments were begun in 14 children for a median duration of 8 days (1-48 days). Three kind of indications were found: DRF antecedent (10 episodes: A group), DRF occurrence during a treatment with conventional Ampho B (7 episodes: B group), age lower than 1 year (3 episodes). 81% of the children were thus treated according to the decisional tree. The clinical tolerance was good in 90% of the cases, with a premedication in half of the cases. The study of the renal function showed a good renal tolerance for 6 episodes out of 9 evaluable in A group, 3 resolutions and 2 stabilisation of the renal failure for the 5 evaluable episodes of the B group. Seven to ten days of treatment by Abelcet were necessary to obtain the renal failure resolved.
  
  
  CONCLUSIONS
  This study confirms the interest of Abelcet in the empirical antifungal treatment in febrile neutropenic children and specially in children having antecedents of DRF related or not to a treatment with conventional Ampho B.
authors.affiliation: Service de pharmacie, hôpital Armand-Trousseau, 26, avenue du Docteur-Arnold-Netter, 75012 Paris, France. Nathalie.leguyader@trs.ap-hop-paris.fr
authors.forename: N
authors.initials: N
authors.lastname: Le Guyader
authors.forename: A
authors.initials: A
authors.lastname: Auvrignon
authors.forename: V
authors.initials: V
authors.lastname: Demontoux
authors.forename: S
authors.initials: S
authors.lastname: Fasola
authors.forename: A
authors.initials: A
authors.lastname: Fratta
authors.forename: B
authors.initials: B
authors.lastname: Pellegrino
authors.forename: G
authors.initials: G
authors.lastname: Benoit
authors.forename: G
authors.initials: G
authors.lastname: Leverger
mesh_terms: D000666:Amphotericin B / Q000627:therapeutic use*; D000935:Antifungal Agents / Q000627:therapeutic use*; D002648:Child; D003404:Creatinine / Q000097:blood; D004338:Drug Combinations; D005334:Fever; D019337:Hematologic Neoplasms / Q000150:complications; D006801:Humans; D007677:Kidney Function Tests; D009503:Neutropenia / Q000188:drug therapy* / Q000209:etiology / Q000382:microbiology; D010713:Phosphatidylcholines / Q000627:therapeutic use*; D010715:Phosphatidylglycerols / Q000627:therapeutic use*; D012189:Retrospective Studies
chemical_list: D000935:Antifungal Agents; D004338:Drug Combinations; D010713:Phosphatidylcholines; D010715:Phosphatidylglycerols; C068538:liposomal amphotericin B; D000666:Amphotericin B; D003404:Creatinine