Oral vs. intravenous empirical antimicrobial therapy in febrile neutropenic patients receiving childhood cancer chemotherapy.

Abstract:

OBJECTIVE:To compare the use of intravenous vs. oral antibiotic therapy. METHODS:All febrile neutropenic patients younger than 18 years old with low risk of complications and receiving chemotherapy were selected. The study was conducted from 2002 to 2005 at the Pediatric Oncology Unit of Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil. Patients were divided into group A and group B and were randomly assigned to receive oral or intravenous therapy. The empirical antimicrobial treatment used for group A consisted in oral ciprofloxacin plus amoxicillin-clavulanate and intravenous placebo, and group B received cefepime and oral placebo. RESULTS:A total of 91 consecutive episodes of febrile neutropenia in 58 children were included in the study. For patients of group A, treatment failure rate was 51.2%; the mean length of hospital stay was 8 days (range 2-10 days). For patients treated with intravenous antibiotic therapy, treatment failure rate was 45.8%; the mean length of hospital stay was 7 days (range 3-10 days). CONCLUSION:There was no difference in the outcome in oral vs. intravenous therapy. There is need of larger randomized trials before oral empirical therapy administered to this population should be considered the new standard of treatment.

journal_name

J Pediatr (Rio J)

journal_title

Jornal de pediatria

authors

Cagol AR,Castro Junior CG,Martins MC,Machado AL,Ribeiro RC,Gregianin LJ,Brunetto AL

doi

10.2223/JPED.1956

subject

Has Abstract

pub_date

2009-11-01 00:00:00

pages

531-5

issue

6

eissn

0021-7557

issn

1678-4782

journal_volume

85

pub_type

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