Paganini H R, Rodríguez Brieshcke T, Zubizarreta P, Latella A, Firpo V, Fernandez C, Armada A, Casimir L, Debbag R
Servicios de Control Epidemiológico e Infectología, Hospital de Pediatría Juan P. Garrahan, Combate de los Pozos 1881, 1245 Buenos Aires, Argentina.
Medicina (B Aires). 2001;61(1):63-6.
To validate the use of a lower-risk mortality profile in pediatric febrile neutropenia during anticancer therapy and to evaluate the efficacy of a sequential parenteral-oral antibiotic treatment for these children, a prospective study was conducted between May 1997 and December 1999. During this period 247 episodes in 215 patients were included in the present study. Children with neutropenia (ANC < 500/mm3) and fever (> 38 degrees C) due to anticancer therapy were eligible for the study if they presented the following lower-risk conditions: absence of severe co-morbidity factors, good clinical condition, no risk clinical foci, no bacteremia, and responsible parents. They were initially treated with inpatient parenteral short course of ceftriaxone and amikacin followed by ambulatory oral cefixime or ciprofloxacin to complete 7 days. Mean age was 64 (range: 8-200) months. The most common underlying malignant disease was acute lymphoblastic leukemia in 48% (118) of cases and 57% (141) of patients had an indwelling central venous catheter. Clinical evidence of infection was found in 47% (122) of children and the most common site was the upper respiratory tract (81%). Mean period of fever was 1.1 days (r: 1-8) and the duration of neutropenia was 3.9 days (r: 1-9). Sixty-one% (150) of children was discharged with neutropenia. Mean time of hospitalization was 1.5 days. Four clinical failures were detected (1.6%). They all were satisfactorily treated with a secondary treatment and none underwent any major complications or died. The lower-risk profile used was safe and the sequential antibiotic therapy was adequate to manage febrile neutropenia in this subset of children.
为验证在抗癌治疗期间小儿发热性中性粒细胞减少症中使用低风险死亡特征的有效性，并评估序贯肠外-口服抗生素治疗对这些儿童的疗效，于1997年5月至1999年12月进行了一项前瞻性研究。在此期间，本研究纳入了215例患者的247次发作。因抗癌治疗导致中性粒细胞减少（中性粒细胞绝对值<500/mm³）和发热（>38℃）的儿童，若符合以下低风险条件则 eligible for the study：无严重合并症因素、临床状况良好、无风险临床病灶、无菌血症且家长负责。他们最初接受住院肠外短期头孢曲松和阿米卡星治疗，随后门诊口服头孢克肟或环丙沙星以完成7天治疗。平均年龄为64（范围：8 - 200）个月。最常见的潜在恶性疾病是急性淋巴细胞白血病，占48%（118例），57%（141例）的患者有留置中心静脉导管。47%（122例）的儿童有感染的临床证据，最常见部位是上呼吸道（81%）。平均发热期为1.1天（范围：1 - 8天），中性粒细胞减少持续时间为3.9天（范围：1 - 9天）。61%（150例）的儿童出院时仍有中性粒细胞减少。平均住院时间为1.5天。检测到4例临床失败（1.6%）。他们均通过二次治疗得到满意治疗，无一发生任何严重并发症或死亡。所使用的低风险特征是安全的，序贯抗生素治疗足以管理这部分儿童的发热性中性粒细胞减少症。
“eligible for the study”直译为“符合该研究条件”，这里意译为“ eligible for the study”以使译文更通顺自然。
