[Efficacy of the combination of ceftazidime/vancomycin in the first line treatment of infection in neutropenic children].

Abstract

UNLABELLED:

Infection is the first reason of mortality in children with bone marrow aplasia. It justifies the immediate treatment initiation before bacteriological cultures results. First line probabilistic treatment must have a bactericidal activity on the pathogens and must be atoxic. The empirical therapy consisted of ceftazidime 100 mg/k/d and vancomycine 40 mg/k/d three times a day. We treated 41 patients, ranged from 0.5 to 17 years (mean 9.5 years). 27 lymphoblastic leukaemias, 10 myeloblastic leukaemias, 4 lymphomas, presenting post therapeutic prolonged aplasia: PMN less than 500/mm3. 23 strains were isolated from 15 patients. 12 Gram+: 7 ceftazidime sensitive, 12 vancomycine sensitive and 11 Gram-: 10 ceftazidime sensitive. Only one is resistant to ceftazidime + vancomycine. Apyrexia was obtained in less than 48 hours in 36 patients. Mean treatment duration was 16 days. Hyperthermia relapsed 17 times and was susceptible to ampho B ten times, although no candida was isolated. When ceftazidime + vancomycine combination failed, other antibiotic treatment was ineffective. There were 4 superinfections (2 in blood, 1 enteric, 1 pharyngeal) and 2 germs were ceftazidime resistant.

IN CONCLUSION:

ceftazidime + vancomycine combination is a very effective treatment of infection in the neutropenic children: 88% success. 95% of the germs are sensitive to, at least, one of the 2 antibiotics. There are very few superinfections. Tolerance is excellent.

• Authors: G Schaison, G Leverger, M Pappo, D Chiche
• Journal: Pathologie-biologie (Pathol Biol (Paris)) Vol. 38 Issue 5 ( Pt 2) Pg. 557-60 (Jun 1990) ISSN: 0369-8114 [Print] France
• Vernacular Title: Efficacité de l'association ceftazidime/vancomycine dans le traitement de première intention des infections des enfants neutropéniques.
• PMID: 2200996 (Publication Type: English Abstract, Journal Article)

Chemical References

• Vancomycin
• Ceftazidime

Topics

• Adolescent
• Agranulocytosis (complications)
• Bacterial Infections (complications, drug therapy, microbiology)
• Ceftazidime (therapeutic use)
• Child
• Child, Preschool
• Drug Therapy, Combination (therapeutic use)
• Female
• Humans
• Infant
• Male
• Neutropenia (complications)
• Vancomycin (therapeutic use)