Chamilos Georgios, Bamias Aristotle, Efstathiou Eleni, Zorzou Pagona M, Kastritis Efstathios, Kostis Evagelos, Papadimitriou Christos, Dimopoulos Meletios A
Department of Clinical Therapeutics, University of Athens Medical School, Athens, Greece.
Cancer. 2005 Jun 15;103(12):2629-35. doi: 10.1002/cncr.21089.
Oral-based antibiotic therapy is the standard of care in the management of cancer patients with low-risk neutropenic fever. Nevertheless, to the authors' knowledge, the best antibiotic regimen and the feasibility of ambulatory treatment have not been clearly defined.
The authors evaluated the efficacy and safety of moxifloxacin as outpatient treatment in cancer patients with febrile neutropenia who were selected according to the recently proposed Multinational Association for Supportive Care in Cancer (MASCC) risk assessment model. Moxifloxacin was given at a dose of 400 mg orally once daily.
Fifty-four patients with solid and hematologic malignancies, the majority of whom (84%) had advanced disease, were included in the current study. The median neutrophil count at the time of study entry was 340/mm3 (range, 20-950/mm3) and the median duration of neutropenia was 4 days (range, 3-14 days). Of 55 neutropenic episodes, 50 (91%) had a successful outcome with a median time to defervescence of 2 days (range, 1-5 days). A multivariate analysis indicated that severe neutropenia (an absolute neutrophil count of < 100 mm3) was the only independent factor associated with treatment failure (P < 0.04). Moxifloxacin was found to be well tolerated and there were no infectious deaths reported.
The results of the current study demonstrated that moxifloxacin was a highly effective and safe regimen in the outpatient treatment of cancer patients with febrile neutropenia.
对于低风险中性粒细胞减少性发热的癌症患者，口服抗生素治疗是标准的治疗方法。然而，据作者所知，最佳的抗生素方案以及门诊治疗的可行性尚未明确界定。
作者评估了莫西沙星作为门诊治疗药物，用于根据最近提出的多国癌症支持治疗协会（MASCC）风险评估模型选择的发热性中性粒细胞减少症癌症患者的疗效和安全性。莫西沙星的给药剂量为每日一次口服400毫克。
本研究纳入了54例实体和血液系统恶性肿瘤患者，其中大多数（84%）患有晚期疾病。研究入组时中性粒细胞计数的中位数为340/mm³（范围为20 - 950/mm³），中性粒细胞减少的中位持续时间为4天（范围为3 - 14天）。在55次中性粒细胞减少发作中，50次（91%）治疗成功，发热消退的中位时间为2天（范围为1 - 5天）。多变量分析表明，严重中性粒细胞减少（绝对中性粒细胞计数<100/mm³）是与治疗失败相关的唯一独立因素（P < 0.04）。发现莫西沙星耐受性良好，未报告有感染相关死亡病例。
本研究结果表明，莫西沙星是门诊治疗发热性中性粒细胞减少症癌症患者的一种高效且安全的方案。
