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short course antibiotic in neutropenic

Minako Mori, Tomoya Kitagawa, Yuya Sasaki, Kazuyo Yamamoto, Takashi Onaka, Akihito Yonezawa, Kazunori Imada
A 63-year-old man had been treated with intensive chemotherapy for acute myeloid leukemia. On the 49th hospital day, he had febrile neutropenia after the second course of induction chemotherapy. On the 53 rd hospital day, he presented with hemoptysis and developed acute respiratory failure requiring ventilator support within several hours. On the 54th hospital day, the patient died with hemorrhagic respiratory infection. Stenotrophomonas maltophilia was detected in bacterial cultures of his blood, bronchoalveolar lavage, and sputum...
May 2012: Kansenshōgaku Zasshi. the Journal of the Japanese Association for Infectious Diseases
Bob Phillips, Ros Wade, Marie Westwood, Richard Riley, Alex J Sutton
INTRODUCTION:   Children and young people who present with febrile neutropenia (FNP) secondary to malignancies or their treatment frequently do not undergo routine chest radiography. With shorter courses of antibiotic therapy, failure to recognise pneumonia and consequent under-treatment could produce significant problems. METHODS:   The review was conducted determine the value of the absence of clinical features of lower respiratory tract infection in excluding radiographic pneumonia at presentation of FNP using Centre for Reviews and Dissemination methods...
August 2012: Journal of Paediatrics and Child Health
Nicklas Sundell, Håkan Boström, Mats Edenholm, Jonas Abrahamsson
AIM: To describe the symptoms, clinical management and short-term outcome in a series of paediatric oncology patients with severe typhlitis following conservative treatment. METHODS: Twelve episodes of severe typhlitis in 11 children with cancer treated at the paediatric oncology ward at Queen Silvias Children's Hospital between 1995 and 2006 were analysed retrospectively. Data on symptoms, radiological findings, laboratory status and treatment as well as outcome were collected and analysed...
March 2012: Acta Paediatrica
Michael Ellis, Roos Bernsen, Hussein Ali-Zadeh, Jörgen Kristensen, Ulla Hedström, Lazaros Poughias, Mark Bresnik, Awad Al-Essa, David A Stevens
A high intermittent dose regimen (group A: 10 mg kg(-1) on day 1, 5 mg kg(-1) on days 3 and 6) was compared with standard dosing (group B: 3 mg kg(-1) per day for 14 days) of liposomal amphotericin B (LAB) for empirical treatment of persistent febrile neutropenia. A total cumulative dose of 1275 mg (group A) and 2800 mg (group B) was administered. Infusion-related adverse drug events, mainly rigors/chills, occurred more frequently with group A (11/45, 24 % infusions) than with group B (12/201, 6 % infusions) (P=0...
November 2009: Journal of Medical Microbiology
Audrey Rousseau, Mohib Morcos, Liliane Amrouche, Elena Foïs, Anne Casetta, Bernard Rio, Agnès Le Tourneaua, Thierry Molina, Antoine Rabbat, Jean-Pierre Marie, Josée Audouin
Stenotrophomonas maltophilia (Sm) pneumonia in immunocompromized hosts is an increasingly common nosocomial infection. Even though resistant to multiple antimicrobials, this gram-negative bacteria usually does not present with a fulminant course leading to a fatal hemorrhagic respiratory infection in neutropenic patients. We report here the case of a 63-year-old woman treated by intensive chemotherapy for acute myeloid leukemia (AML) who presented while severely neutropenic and thrombocytopenic a Sm pulmonary infection with hemoptysis leading to death in 48 h...
June 2004: Leukemia & Lymphoma
T Lehrnbecher, A Stanescu, J Kühl
BACKGROUND: Since the optimal duration of antibiotic therapy in febrile neutropenic patients is not clear, we evaluated the safety and efficacy of short courses of intravenous antibiotic treatment in selected pediatric cancer patients admitted for fever and neutropenia. PATIENTS AND METHODS: We retrospectively analyzed the clinical course of children with chemotherapy-induced neutropenia and fever. All patients were treated with empirical intravenous antibiotics...
January 2002: Infection
N C McBride, J D Cavenagh, M C Ward, I Grant, S Schey, A Gray, A Hughes, M J Mills, P Cervi, A C Newland, S M Kelsey
We treated 33 patients with a variant of the standard 3 weekly CHOP regime, replacing doxorubicin with liposomal daunorubicin (DaunoXome, NeXstar Pharmaceuticals) 120 mg/m2 (COP-X). Eighteen subjects had relapsed/refractory aggressive NHL and 15 had indolent NHL/CLL. Median number of courses received was 4 (1-8). Thirty-two patients were evaluable for efficacy and 26 (81%) responded. 88% of patients with aggressive NHL responded; three (18%) patients achieved complete remission (CR), 12 (70%) achieved partial remission (PR), 1 (6%) patient had stable disease (SD) and 1 (6%) patient progressed through treatment...
June 2001: Leukemia & Lymphoma
I Hann, C Viscoli, M Paesmans, H Gaya, M Glauser
The object of this study was to determine whether there were any differences between the 'typical' child with fever and neutropenia and their adult counterpart with regard to infection type and outcome, by analysis of 3080 patients, including 759 children < 18 years of age and 2321 adults. These represented patients randomized in previous trials, between 1986 and 1994, which compared empirical antibiotic regimens for fever in neutropenic patients. There were fewer childhood acute myeloid leukaemia patients than adults but more acute lymphoblastic leukaemia cases and more with solid tumours undergoing intensive myelosuppressive therapy...
December 1997: British Journal of Haematology
P Mahendra, S K Jacobson, S Ager, G Bass, P Barker, D Johnson, T P Baglin, R E Marcus
The effectiveness of short-course intravenous antibiotics concurrent with prophylactic oral ciprofloxacin in the treatment of neutropenic fever was studied in 81 patients undergoing autologous bone marrow or peripheral blood progenitor cell transplantation (ABMT or PBPCT). During the neutropenic period following ABMT or PBPCT, 10/81 (12%) patients did not require treatment with intravenous antibiotics. Seventy-one patients required antibiotics. Forty-seven of the 71 (66%) responded to 72 h treatment with gentamicin, azlocillin or ceftazidime, and vancomycin...
1996: Acta Haematologica
J J Cornelissen, M Rozenberg-Arska, A W Dekker
To evaluate the mortality and morbidity associated with early discontinuation of intravenously administered antibiotics, we prospectively examined the incidence and cause of recurrent fever in patients with persistent neutropenia who responded to a short course of intravenous antibiotic therapy. Preventive measures included the use of oral ciprofloxacin as prophylaxis for infection by gram-negative bacteria during the entire neutropenic episode. The rate of response to either initial or modified intravenous antibiotic therapy was 96% (149 of 156 episodes of fever)...
November 1995: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
S Martin-Algarra, M R Bishop, S Tarantolo, M K Cowles, E Reed, J R Anderson, J M Vose, P Bierman, J O Armitage, A Kessinger
The use of hematopoietic growth factors (HGFs) in the allogeneic transplant setting has sometimes been avoided for fear of stimulating leukemic cell growth and intensifying graft-vs.-host disease (GVHD). However, neither an increase in relapse rate nor an aggravation of GVHD has been routinely described when HGFs are used after allogeneic bone marrow transplantation (allo-BMT). Early outcomes after HLA-matched allo-BMT in 26 patients with hematologic malignancies treated with recombinant human granulocyte colony-stimulating factor (rhG-CSF) or recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF) from the day of transplantation were analyzed...
December 1995: Experimental Hematology
S H Zinner, M Dudley, J Blaser
Neutropenic patients are at risk of serious infection caused by gram-negative bacilli and staphylococci. The mortality rate associated with gram-negative bacteremia in these patients is extremely high, especially in those with persistent and profound granulocytopenia. In these latter patients, the best results have been obtained by administering combinations of antibiotics in which both agents are active and/or show in vitro synergism against the infecting organism. Most combinations include an aminoglycoside such as amikacin and a broad-spectrum beta-lactam antibiotic, such as azlocillin, mezlocillin, piperacillin, or ceftazidime...
June 30, 1986: American Journal of Medicine
(no author information available yet)
In the four EORTC International Antimicrobial Therapy Cooperative Group trials, the frequency of gram-positive isolates has increased significantly from 29% of single-organism bacteraemias in trial I (1973-1976) to 41% in trial IV (1983-1985). In trial IV febrile and neutropenic (less than 1000 polymorphonuclear lymphocytes per microliter) cancer patients were randomized prospectively to receive either azlocillin plus a long course (at least 9 days) of amikacin, or ceftazidime plus a short course (3 days) of amikacin, or ceftazidime plus a long course of amikacin...
1990: European Journal of Cancer
A H Kaplan, D J Weber, L Davis, F Israel, R J Wells
To evaluate their policy of discontinuing broad spectrum antibiotics in patients with negative cultures who become afebrile but remain neutropenic, the authors retrospectively reviewed the charts of all pediatric patients diagnosed with cancer between 1980 and 1986. Two hundred seventy-one children had 385 admissions for infectious complications during the study period. In 39 of those episodes (9%), the patients had negative cultures, became afebrile, and were discharged with absolute neutrophil counts of less than 1000 cells/mm3 (mean 390 cells/mm3)...
December 1991: American Journal of the Medical Sciences
M Nobbenhuis, F J Cleton
Febrile neutropenic events (FNE) were studied in 90 patients on chemotherapy protocols for solid tumours, from 1986 to 1990. All patients received intensive chemotherapy with a high dose intensity. There were 51 FNE admissions in 31 patients, with an average event rate of 1.6/patient. The average periods of granulocytopenia, fever and admission were 3.5, 2.7 and 5.4 days respectively. The management of FNE consisted of accurate clinical observation and antibiotic treatment if indicated by symptoms of infection or by bacteriological cultures...
1992: Journal of Cancer Research and Clinical Oncology
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