Antibiotic Sequential Therapy for Febrile Neutropenia in Pediatric Patients With Malignancy

Abstract

Children suffering malignant diseases can experience phases of bone marrow depression during intensive chemotherapy. The influence of antibiotic sequence therapy on the course of diseases was examined in 41 pediatric patients with malignant diseases. Inclusion criteria were neutropenia (ANC < 500/microL), rectal body temperature over 38.5 degrees C, and increased C-reactive protein (CRP, cutoff > 5.0 mg/L). The first stage of therapy comprised the following antibiotics: piperacillin, teicoplanin, and gentamicin. In stage 2 imipenem, teicoplanin, and tobramycin were administered. Fluconazole was the antifungal drug of choice in stages 1 and 2. In the first level of antibiotic therapy 68% of the patients showed a positive reaction. The C-reactive protein was a sensitive parameter, which significantly decreased with 3 days of therapy. A total of 72% of the bacteriological smears were sterile. All patients survived the septic phase.

Validity of Frozen Sections for Analysis of Periprosthetic Loosening Membranes

“…Sensitive parameters such as the ESR and CRP are not specific. Often they are depressed by antibiotic therapy [4,14]. Furthermore, sensitivity and specificity are influenced and reduced by several factors, including accompanying illnesses.…”

DPOAE Changes in Young Children With Confirmed Hearing Loss Due to Ototoxicity

“…As immunosuppression is a side effect of chemotherapy that makes the cancer patient susceptible to infection, the use of potentially ototoxic aminoglycoside antibiotics is often warranted (Bernig, Weigel, Mukodzi, & Reddemann, 2000;Seligmann, Podoshin, Ben-David, Fradis, & Goldsher, 1996). Carboplatin is also increasingly being used in chemotherapy protocols, often as a cisplatin substitute.…”