Evaluation of ticarcillin/clavulanic acid versus ceftriaxone plus amikacin for fever and neutropenia in pediatric patients with leukemia and lymphoma

Evaluation of ticarcillin/clavulanic acid versus ceftriaxone plus amikacin for fever and neutropenia in pediatric patients with leukemia and lymphoma

Author Petrilli, Antonio Sergio Autor UNIFESP Google Scholar
Cypriano, Monica Autor UNIFESP Google Scholar
Dantas, Lenice Silva Autor UNIFESP Google Scholar
Lee, Lúcia Martino Autor UNIFESP Google Scholar
Luisi, Maria Flávio Augusto Vercillo Autor UNIFESP Google Scholar
Silva, Katia Veronica Torres B. Autor UNIFESP Google Scholar
Pereira, Carlos Alberto Pires Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract BACKGROUND: The empirical use of antibiotic treatments is widely accepted as a means to treat cancer patients in chemotherapy who have fever and neutropenia. Intravenous monotherapy, with broad spectrum antibiotics, of patients with a high risk of complications is a possible alternative. METHODS: We conducted a prospective open-label, randomized study of patients with lymphoma or leukemia who had fever and neutropenia during chemotherapy. Patients received either monotherapy with ticarcillin/clavulanic acid (T) or ceftriaxone plus amikacin (C+A). RESULTS: Seventy patients who presented 136 episodes were evaluated, 68 in each arm of the study. The mean neutrophil counts at admission were 217cells/mm³ (T) and 201cells/mm³ (C+A). The mean duration of neutropenia was 8.7 days (T) and 7.6 days (C+A). Treatment was successful without the need for modifications in 71% of the episodes in the T group and 81% in the C+A group (p=0.23). Treatment was considered to have failed because of death in two episodes (3%) in the T group and three episodes (4%) in the C+A group, and because of a change in the drug applied in one episode in the T group and two episodes in the C+A group. Overall success was 96% (T) and 93% (C+A). Adverse events that occurred in group T were not related to the drugs used in this study. CONCLUSION: In pediatric and adolescent patients with leukemia or lymphoma, who presented with fever and neutropenia, during chemotherapy, ticarcillin/clavulanic acid was as successful as the combination of ceftriaxone plus amikacin. It should be considered an appropriate option for this group of patients at high risk for infections.
Keywords Fever
neutropenia
leukemia
lymphoma
ticarcillin
ceftriaxone
Language English
Date 2003-04-01
Published in Brazilian Journal of Infectious Diseases. Brazilian Society of Infectious Diseases, v. 7, n. 2, p. 111-120, 2003.
ISSN 1413-8670 (Sherpa/Romeo)
Publisher Brazilian Society of Infectious Diseases
Extent 111-120
Origin http://dx.doi.org/10.1590/S1413-86702003000200003
Access rights Open access Open Access
Type Article
SciELO ID S1413-86702003000200003 (statistics in SciELO)
URI http://repositorio.unifesp.br/handle/11600/1697

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