López HMA, Alvarado IM, Jiménez ARM, González ACM

Language: Spanish
References: 24
Page: 176-182
PDF size: 65.74 Kb.

ABSTRACT

Objective: To know if gatifloxacin, used in the empiric treatment of febrile neutropenia, offers more or the same effectiveness as classical combination amikacine+ceftriaxone+vancomycin.
Patient and methods: Patients older than 15 years with acute leukemia, in treatment with chemotherapy were included. Fever › 38ºC and neutrophils ‹0.5 x 109/L were considered febrile neutropenia. Patients were assigned to one of two groups: amikacine + ceftriaxone and vancomycin (if after three days fever persisted), or intravenous gatifloxacin. In both groups amphotericin B was added when after 7 days fever persisted. Both groups received filgrastim. When both fever and other evidence of infection disappeared before 15 days it was considered a success. Death and persistence of fever after 14 days were considered a failure.
Results: Forty patients were included, twenty in each group. There were no differences between both groups, regarding age, sex, leukemia type, intensity of chemotherapy, magnitude of neutropenia, isolated germs neither localization and severity of the infection. The average duration of fever was of five days in both groups. There was one failure in the group of amikacine and two in that of gatifloxacin (p = 0.59). Two patients were excluded in this second group, inasmuch as they received vancomycin. The successes were of 19 and 16. When concluding the episode of febrile neutropenia, the neutrophils were of 1.2 x 10⁹/L and 0.5 x 10⁹/L (p = 0.04). There was a case of systemic micosis in the first group and four in the second one.
Conclusion: Gatifloxacin, in the treatment of febrile neutropenia of patients with acute leukemia, is as effective as the combination of amikacine + ceftriaxone + vancomycin.

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