Antibiotic sequential therapy for febrile neutropenia in pediatric patients with malignancy

Children suffering malignant diseases can experience phases of bone marrow depression during intensive chemotherapy. The influence of antibiotic seque nce therapy on the course of diseases was examined in 41 pediatric patients with malignant diseases. Inclusion criteria were neutropenia (ANC < 500/mu L), rectal body temperature over 38.5 degrees C, and Increased C-reactive protein (CRP, cutoff > 5.0 mg/L). The first stage of therapy comprised the following antibiotics: piperacillin, teicoplanin, and gentamicin. In stage 2 imipenem, teicoplanin, and tobramycin were administered. Fluconazole was the antifungal drug of choice in stages I and 2. In the first level of anti biotic therapy 68% of the patients showed a positive reaction. The C-reacti ve protein was a sensitive parameter which significantly den eased with 3 d ays of therapy. A total of 72% of the bacteriological smears were sterile. All Patients survived the septic phase.