[Penicillin and aminoglycoside in febrile neutropenia]. / Penicillin og aminoglykosid ved febril nøytropeni.
Tidsskr Nor Laegeforen
; 128(23): 2738-40, 2008 Dec 04.
Article
em Nor
| MEDLINE
| ID: mdl-19079423
ABSTRACT
BACKGROUND:
Fever in patients with neutropenia may indicate a serious/lethal underlying bacterial sepsis. In Norway, penicillin G in combination with an aminoglycoside is the therapy of choice for this indication. In most countries, empiric monotherapy starts with a broadspectrum betalactam antibiotic. MATERIAL ANDMETHODS:
Review of the literature and expert opinion identified five Norwegian studies evaluating therapy with penicillin in combination with an aminoglycoside in febrile neutropenia. These studies are presented and assessed.RESULTS:
Mortality in febrile neutropenia is approximately 5 % both in the Norwegian studies and in larger international trials. Therapy which starts with penicillin and an aminoglycoside needs to be modified more frequently(60 %) than when it starts with broadspectrum betalactam monotherapy (40 %). The Norwegian studies span 20 years. Clinical blood culture isolates from this group of patients show stable resistance patterns.INTERPRETATION:
In spite of methodological weaknesses, all the studies have the sameconclusion:
penicillin G in combination with an aminoglycoside is an effective and safe initial empiric therapy provided it is modified when the clinical course is unsatisfactory.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Penicilina G
/
Febre
/
Aminoglicosídeos
/
Antibacterianos
/
Neutropenia
Limite:
Humans
Idioma:
Nor
Revista:
Tidsskr Nor Laegeforen
Ano de publicação:
2008
Tipo de documento:
Article