Treatment of gram‐positive septicemia in cancer patients

Abstract

Seventy‐eight pediatric cancer patients were treated for gram‐positive bacterial septicemia during a 10‐year period (1968 – 1977). Sixty‐one (78%) of the patients were granulocytopenic (PMNs <500/mm3) at the onset of the septic episode. All the patients whose granulocytopenia resolved (PMNs > 500/mm3) within one week of therapy recovered without sequelae. However, 7 of 15 patients (47%) who remained granulocytopenic for more than 7 days and who were treated with a single antibiotic developed a second sepsis with a gram‐negative organism. In contrast, second infections were not observed in 24 patients with PMNs < 500/mm3 for more than 7 days who were treated with broad spectrum antibiotics (p < 0.002), suggesting that a broad‐spectrum antibiotic regimen may be preferable when a cancer patient has prolonged granulocytopenia. Copyright © 1980 American Cancer Society