Oral gatifloxacin in the outpatient treatment of children with cancer fever and neutropenia.
BACKGROUND
Fever in neutropenic (FN) patients requires immediate broad-spectrum antibiotics, however, such patients do not represent a homogeneous population and the majority of them are at low risk of developing complication. Gatifloxacin (GA) is an alternative, though it has not been thoroughly studied in Pediatrics yet. The aim of this study was to evaluate oral GA in oncology pediatric patients with FN and low risk of infectious complications.


METHODS
We conducted a prospective study in patients submitted to chemotherapy and FN, from the ages of 3 to 21 years old, with solid tumors, acute lymphoid leukemia, and lymphomas without comorbidities and treated as outpatient with oral GA. Safety and adverse effects were monitored.


RESULTS
We evaluated 108 patients with 201 episodes of FN. The average age was 10.8 years, 64.8% of the patients were male. Osteosarcoma accounted for 22% of the episodes, rhabdomyosarcoma for 13%, acute lymphoid leukemia, lymphomas and Ewing sarcoma, for 11% each. Among the 174 episodes exclusively treated as outpatients, the average duration of neutropenia was 4.8 days, the average duration of fever was 2.4 days; the average duration of the treatment was 8.1 days. The treatment was successful in 75.9%, analyzing only the first episodes. No patient died during the study. Adverse events included diarrhea, vomiting, increased liver enzymes, arthralgia, and ECG changes.


CONCLUSIONS
Oral GA is effective and safe in the management of oncology pediatric patients with FN at low risk of infectious complications in the outpatient setting.
Petrilli
Antoniosérgio
A
Pediatric Oncology Institute-GRAACC-Federal University of São Paulo (UNIFESP-EPM), São Paulo, SP, Brazil. iopepm@dialdata.com.br
Altruda Carlesse
Fabianne
F
Alberto Pires Pereira
Carlos
C
D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000553:Ambulatory Care; D000890:Anti-Infective Agents / Q000008:administration & dosage; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005260:Female; D005334:Fever / Q000188:drug therapy / Q000209:etiology; D024841:Fluoroquinolones / Q000008:administration & dosage*; D000077734:Gatifloxacin; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000150:complications* / Q000188:drug therapy; D009503:Neutropenia / Q000188:drug therapy* / Q000209:etiology; D016896:Treatment Outcome
D000890:Anti-Infective Agents; D000970:Antineoplastic Agents; D024841:Fluoroquinolones; D000077734:Gatifloxacin