PMID: 3889253Jun 1, 1985

Management in the febrile, neutropenic patient with cancer: therapeutic considerations

The Journal of Pediatrics
A E Brown

Abstract

Infection is the principal cause of death in neutropenic children and adults with neoplastic diseases. Various antibiotic regimens have been studied in clinical trials in an attempt to reduce this mortality. Recent trials have compared newer combinations of antibacterial agents (double beta-lactams) or monotherapy with the standard aminoglycoside-beta-lactam combinations. No significant differences are demonstrated in these trials with regard to efficacy. Emphasis has been on the reduction of toxicity. Although nephrotoxicity, ototoxicity, and hypokalemia have been of concern in the past and continue to be important, newer problems have emerged that involve disorders of coagulation, for example, prolongation of prothrombin time, disorders of platelet function, and clinical bleeding. Superinfection and the emergence of resistance during therapy have also been problematic. Cost must be considered an important factor in determining the selection of an antibacterial regimen. The combination of an aminoglycoside and a beta-lactam antibiotic remains the standard against which future combinations or monotherapy must be judged in clinical trials involving the febrile, neutropenic patient with cancer.

References

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May 13, 2009·The Journal of Infectious Diseases·Richard T GrayDavid P Wilson

Citations

Nov 20, 2002·Journal of Pediatric Hematology/oncology·Douglas J ScothornV M Aquino
Dec 1, 1991·The American Journal of the Medical Sciences·A H KaplanR J Wells
May 1, 1989·Current Problems in Pediatrics·R A Wood, H A Sampson
Jul 1, 1993·Disease-a-month : DM·A S Rosenberg, A E Brown
Feb 1, 1989·Australian and New Zealand Journal of Medicine·J L BlakeyH Ekert
Oct 30, 2004·Pediatric Blood & Cancer·Ronald M Kline, Elizabeth P Baorto
May 1, 1996·Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer·N MuisJ Dankert

Related Concepts

Agranulocytosis
Aminoglycosides
Bacteriocidal Agents
Polychemotherapy
Fever
Lactims
Differential White Blood Cell Count Procedure
Malignant Neoplasms
Neutropenia
Neutrophil Band Cells

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