Cephalosporins 4th Generation in Management of Febrile Neutropenia in High Risk Children with Cancer. A Prospective Study Department of Pediatric Oncology, Faculty Hospital Motol

Overview

Despite to development and use a new, modern broad-spectrum antibiotic infection remains the most serious complication of intensive anticancer therapy in children. The spectrum of microorganisms in neutropenic cancer patients has changed during the last two decades. In most centers, gram-positive cocci have become the most common isolates. Treatment of these critically ill patients has become the major unsolved problem. We performed a prospective randomized study to determine the efficacy of both cephalosporins 4th generation in combination with glykopeptide in cancer children with febrile neutropenia. There were 19 patients with advanced malignancies in group A and 17 in group B. Both groups were comparable according to age, sex, disease and treatment intensity. More than 60% of patients (68% in group A and 64% in group B) respond well and did not received additional 2nd or 3rd line therapy. Three patients died due to sepsis. There were no cephalosporins related toxicity’s. There was no difference between cefapim and cefpirom effect. In conclusion combination of cephalosporins 4th generation and glykopeptide as an empiric first line choice seems to be very effective promising.

Key words:
febrile neutropenia, children, antibiotics, cephalosporins