Engelsk titel: Penicillin and aminoglycoside in febrile neutropenia
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Författare:
Torpfoss D
;
Höiby EA
;
Holte H
;
Kvalöy S
Email: dag.torfoss@radiumhospitalet.no
Språk: Nor
Antal referenser: 23
Dokumenttyp:
Översikt
UI-nummer: 09011676
Sammanfattning
BACKGROUND : Fever in patients with neutropenia may indicate a serious/lethal underlying bacterial sepsis. In Norway, penicillin G in combination with an aminoglycoside is the therapy of choice for this indication. In most countries, empiric monotherapy starts with a broadspectrum betalactam antibiotic.
MATERIAL AND METHODS : Review of the literature and expert opinion identified five Norwegian studies evaluating therapy with penicillin in combination with an aminoglycoside in febrile neutropenia. These studies are presented and assessed.
RESULTS : Mortality in febrile neutropenia is approximately 5 % both in the Norwegian studies and in larger international trials. Therapy which starts with penicillin and an aminoglycoside needs to be modified more frequently(60 %) than when it starts with broadspectrum betalactam monotherapy (40 %). The Norwegian studies span 20 years. Clinical blood culture isolates from this group of patients show stable resistance patterns.
INTERPRETATION : In spite of methodological weaknesses, all the studies have the same conclusion: penicillin G in combination with an aminoglycoside is an effective and safe initial empiric therapy provided it is modified when the clinical course is unsatisfactory.