Fiebre y neutropenia en niños con cáncer: evaluación de un protocolo terapéutico con monoterapia

Abstract

BackgroundTraditionally, fever and neutropenia in cancer patients has been managed with an association of two or more antibiotics. In recent years, monotherapy has emerged as an adequate option. We began a new empirical antibiotic protocol in 2001, including monotherapy as initial treatment for a selected group of patients.ResultsForty seven patients had 98 fever and neutropenia episodes and 97 were included in the protocol. Leukemia and lymphomas were the most common underlying diagnosis. In most cases, no infection focus was found. In comparison with our previous series, we found an increment in gramnegative sepsis incidence and the disappearance ofStaphylococcus epidermidis as an etiological agent. Initial treatment according to protocol was not modified in 69/97 (71,2%) and 48/67 (71,6%) were treated with monotherapy. Only 5/97 patients were readmitted and finished treatment in the hospital without any further complications.ConclusionIn conclusion we managed to treat our patients effectively and safely, with early discharge from the hospital.