Department of Pharmacy, Sunnybrook Health Sciences Centre;
Can J Infect Dis Med Microbiol. 2009 Winter;20(4):e145-52. doi: 10.1155/2009/631969.
At Sunnybrook Health Sciences Centre in Toronto, Ontario, the recommended empiric regimen for febrile neutropenia has been cefazolin and tobramycin for at least 25 years. However, we had no objective data to reassure us that patient mortality had not increased over the past five years.
A retrospective chart review of 48 episodes occurring in 44 patients admitted for the treatment of febrile neutropenia secondary to chemotherapy in 2002, and initially managed with cefazolin and tobramycin was conducted. Prospective data from 48 episodes in 2007 had previously been collected. Patients who developed febrile neutropenia while in hospital were excluded. The primary objective of the present study was to compare the all-cause mortality in 2007 with that from 2002.
There were no statistically significant differences between the groups (P>0.05). All-cause mortality in 2007 was 8.3% (four of 48) compared with 10.4% (five of 48) in 2002 (P=1). All deaths occurred in patients considered to be at high risk according to the Talcott score.
Mortality has not increased in the past five years with the use of empiric cefazolin and tobramycin for the treatment of patients admitted with febrile neutropenia at Sunnybrook Health Sciences Centre. Rates are comparable with those reported in the literature for similar patients. The results of the present study provide reassurance that the regimen continues to be effective for lower-risk febrile neutropenic patients.
在安大略省多伦多的桑尼布鲁克健康科学中心，发热性中性粒细胞减少症的经验性治疗方案推荐使用头孢唑林和妥布霉素至少 25 年。然而，我们没有客观数据来保证在过去五年中患者死亡率没有增加。
对 2002 年因化疗引起的发热性中性粒细胞减少症而住院接受治疗的 44 例患者的 48 例发热性中性粒细胞减少症患者进行回顾性病历审查，这些患者最初使用头孢唑林和妥布霉素进行治疗。2007 年之前已经收集了 48 例发热性中性粒细胞减少症患者的前瞻性数据。排除在住院期间发生发热性中性粒细胞减少症的患者。本研究的主要目的是比较 2007 年和 2002 年的全因死亡率。
两组之间无统计学差异（P>0.05）。2007 年的全因死亡率为 8.3%（48 例中有 4 例），而 2002 年的全因死亡率为 10.4%（48 例中有 5 例）（P=1）。所有死亡均发生在根据 Talcott 评分被认为是高危的患者中。
在过去五年中，使用经验性头孢唑林和妥布霉素治疗因发热性中性粒细胞减少症住院的患者，在桑尼布鲁克健康科学中心的死亡率没有增加。发生率与文献中报道的类似患者相似。本研究的结果提供了保证，该方案继续对低危发热性中性粒细胞减少症患者有效。
