Tratamiento antimicrobiano en niños con neutropenia febril de alto riesgo

Abstract

Background: In children with cancer and high risk febrile neutropenia (HRFN), the initial empirical treatment used in our hospital for 5 years includes the association of Cloxacillin + Ceftazidime + Amikacin. There is no chilean literature that reviews the effectiveness of this therapy. Objective: Evaluate the clinical and microbiological effectiveness of this associated therapy in children with HRFN. Method: A prospective-descriptive study evaluating children with HRFN admitted at Hospital Luis Calvo Mackenna between January 2005-August 2006. Results: 100 HRFN episodes were evaluated. In 48% of cases, the antimicrobial treatment was considered effective, whereas in 52% of episodes the therapy required modifications (15% cases within the first 72 hours). The most frequent diagnoses were fever without clinical focus (51%) and sepsis (13%). 36% had microbiological identification and the most frequently isolated bacteria were Escherichia coli (9%) and Staphylococcus aureus (9%). Conclusions: A favorable answer with the initial empirical therapy was obtained for 48% of cases; meanwhile in the remaining episodes, 28% required antibiotics modifications without justification. This fact remarks the importance of following the established guidelines for antimicrobial treatment modification in these patients.