Schrøder H, Lassen B T, Andersen S T, Hansen U S, Møller J K
Arhus Universitetshospital, Skejby Sygehus, børneonkologisk afdeling.
Ugeskr Laeger. 1998 Sep 14;160(38):5487-90.
The purpose of this study was to describe the pattern of bacterial infections in children with acute lymphoblastic leukemia. Forty-six children with ALL were treated for 119 febrile episodes. Antibiotic therapy was initiated with ampicillin and gentamicin, +/- dicloxacillin and lasted for 5-8 days. Bacterial cultures were positive in 36 of 119 febrile events. At the beginning of the febrile disease there was no difference in CRP and neutrophil count between children with positive and negative blood cultures. The maximum CRP was, however, significantly higher in children with positive blood cultures. In 75% there was no need to change the initial antibiotic treatment with ampicillin and gentamicin +/- dicloxacillin. If the temperature has been normal for 2-3 days and the neutrophil count is increasing it appears safe to discontinue the antibiotic therapy after five days when blood cultures are negative and after 7-8 days when cultures are positive.
本研究的目的是描述急性淋巴细胞白血病患儿的细菌感染模式。46例急性淋巴细胞白血病患儿因119次发热发作接受治疗。抗生素治疗起始采用氨苄西林和庆大霉素,±双氯西林,持续5 - 8天。119次发热事件中有36次细菌培养呈阳性。在发热疾病开始时,血培养阳性和阴性的患儿之间C反应蛋白(CRP)和中性粒细胞计数无差异。然而,血培养阳性患儿的最高CRP显著更高。75%的情况下无需更改初始的氨苄西林和庆大霉素±双氯西林抗生素治疗。如果体温已正常2 - 3天且中性粒细胞计数在增加,当血培养阴性时,5天后停用抗生素治疗似乎是安全的;当培养阳性时,7 - 8天后停用抗生素治疗似乎是安全的。