Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 2 de 2
Filtrar
Mais filtros

Base de dados
Tipo de estudo
País/Região como assunto
Ano de publicação
Tipo de documento
País de afiliação
Intervalo de ano de publicação
1.
Pediatr Infect Dis J ; 12(11): 916-21, 1993 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-8265281

RESUMO

Antibiotic monotherapy is increasingly an option for the initial empiric treatment of febrile neutropenic cancer patients. We noted in a previous study that response to empiric therapy was related more to disease classification (solid tumors vs. leukemia) than to the regimen chosen. In the present study we based empiric monotherapy on the underlying disease in treating 240 episodes of fever and neutropenia in 145 children. Patients with leukemia or Stage III/IV non-Hodgkin's lymphoma (higher risk group) were treated with imipenem-cilastatin, whereas those with solid tumors or Stage I/II non-Hodgkin's lymphoma (lower risk group) received ceftriaxone. The regimens were modified in 15% of lower risk and 45% of higher risk episodes. Overall successful outcomes were obtained in 93.2% of the higher risk (n = 119) and 97.5% of the lower risk (n = 121) episodes. The two groups differed significantly in duration of neutropenia, frequency of positive blood cultures and superinfection and the need for modification of the monotherapy (P < 0.05). Empiric monotherapy based on primary disease appears to be safe and effective for febrile neutropenic children with cancer at our Brazilian institution. Further studies will be needed before these findings can be generalized to patient populations in other settings.


Assuntos
Ceftriaxona/uso terapêutico , Cilastatina/uso terapêutico , Febre/complicações , Febre/tratamento farmacológico , Imipenem/uso terapêutico , Neoplasias/complicações , Neutropenia/complicações , Neutropenia/tratamento farmacológico , Adolescente , Antibacterianos/uso terapêutico , Criança , Pré-Escolar , Combinação Imipenem e Cilastatina , Combinação de Medicamentos , Feminino , Humanos , Lactente , Leucemia/complicações , Linfoma não Hodgkin/complicações , Masculino
2.
AMB Rev Assoc Med Bras ; 37(4): 173-80, 1991.
Artigo em Português | MEDLINE | ID: mdl-1668624

RESUMO

Based on our previous experience treating children with cancer, fever and neutropenia we selected two different empirical regimens: Ceftriaxone once a day, for patients with solid tumors and lymphomas I-II (Low Risk group--LR) and Imipenem for patients with leukemias and lymphomas III-IV (High Risk group--HR). From Oct 1988 to Nov 1989, 121 episodes of fever (F+) and granulocytopenia (G+) in LR Group and 119 in HR Group were studied: the HR had 51.3% documented infections and the LR 58.7%. In the HR Group the following organisms were isolated from the blood cultures: Gram + 52%, Gram - 20% and fungal 28%. In the LR Group 78% of the organisms were Gram+. Positive blood cultures was 21% for the HR Group and 8.3% for the LR Group. There were 23.5% superinfections in the HR Group vs 5.7% in the LR. The mean time and the median time of granulocytopenia was 11.5 and 8 days (HR) and 6.9 and 6.0 days (LR), respectively. There were 14.5% (LR) and 45.4% (HR) modifications to the initial empirical antibiotic regimen (Amphotericin B, Vancomycin and Amikacin). The overall success rate was 97.6% (LR) and 94.2% (HR) and for documented infection the success rate was 95.7% (LR) and 91.8% (HR). We conclude that: a) The allocation of patients to two risk groups aiming to use distinguished therapy, allowed us to delineate two different populations, predominantly based on time of granulocytopenia, disappearance of fever, rate of superinfection, causative organisms and need of additional drugs to the initial scheme.(ABSTRACT TRUNCATED AT 250 WORDS)


Assuntos
Infecções Bacterianas/tratamento farmacológico , Ceftriaxona/uso terapêutico , Febre/tratamento farmacológico , Imipenem/uso terapêutico , Neoplasias/complicações , Neutropenia/tratamento farmacológico , Adolescente , Infecções Bacterianas/etiologia , Brasil , Criança , Febre/complicações , Fungos/isolamento & purificação , Bactérias Gram-Negativas/isolamento & purificação , Bactérias Gram-Positivas/isolamento & purificação , Humanos , Leucemia/complicações , Linfoma/complicações , Neoplasias/terapia , Neutropenia/complicações
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA